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Can We Improve Visual Acuity After Intrastromal Corneal Ring Segments Implantation for Keratoconus and Post LASIK Ectasia

  • Adel Barbara
  • Sajjad Abbas
  • Ramez Barbara
Chapter

Abstract

Keratoconus (KC) is an ectatic corneal disease which causes irregular astigmatism that cannot be corrected by spectacles. The irregular astigmatism leads to loss of uncorrected and corrected visual acuity (VA) and leads to a deterioration in the quality of the vision. Contact lenses (CL) improves the VA but cannot be tolerated in many cases due to a variety of reasons including loss of motivation and topical or allergic conjunctivitis which is frequently seen in patients with KC.

Intrastromal corneal ring segments (ICRS) are crescent shape PMMA segments, produced in different geometric shapes, thicknesses and lengths. They are inserted in the periphery of the cornea at a depth of 70–80% of the corneal thickness as measured by pachymetry at the incision site.

ICRS flatten and regularize the cornea, reduce both the myopia as well as the regular and irregular astigmatism and consequently improves uncorrected and best spectacle corrected visual acuity (UCVA and BSCVA).

In some cases the functional results are not satisfactory after the insertion of the ICRS, in others we already know, prior to implantation, that improvement in VA will not be satisfactory. Consequently ICRS may be combined or followed by additional treatment, this chapter will explore the available treatments to enhance/improve results after ICRS.

Keywords

Keratoconus Intrastromal corneal ring segments (ISCR) Collagen corneal crosslinking (CXL) Astigmatism Photorefractive keratectomy (PRK) LASIK Ectasia Packic IOL.INTACS Ferrara rings Kerarings 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Adel Barbara
    • 1
  • Sajjad Abbas
    • 2
  • Ramez Barbara
    • 3
  1. 1.Medical Director of IVISIONRefractive Surgery and Keratoconus Treatment CenterHaifaIsrael
  2. 2.Bournemuoth Eye UnitRoyal Bournemouth HospitalBournemouthUK
  3. 3.Southampton Eye UnitSouthampton General HospitalSouthamptonUK

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