Intracorneal ring implantation using Intralase® with partial coverage of the cone in a patient after an alkaline injury

Abstract

Purpose: To report the use of intracorneal ring segment (ICRS) implantation in a case of severe corneal thinning and irregularity secondary to alkali burn.Case report: A 33-year-old man who had a history of ocular alkali burn in the right eye was admitted. His best corrected visual acuity was 0.16 with manifest refraction of +5.00 (-7.00 x 180 degrees). Orbscan II (R) revealed steepening of >53 D superiorly, excessive thinning inferiorly with thinnest pachymetric reading of 269 mu m. Two KeraRing (R) segments, 200 mu m thick and 90 degrees arced, were implanted. During intrastromal channel creation by Intralase (R), the inferior half of the applanating cone was covered by a gelatinous paper to prevent the penetration of the laser beam into the anterior chamber. In the first year postoperation, best corrected visual acuity was 0.7 with manifest refraction of +1.50 (-3.50 x 35 degrees). Visante (R) opticial coherence tomography displayed ICRS at a depth of similar to 370 similar to mu m.Conclusion: ICRS implantation with this novel approach may be an option in eyes with severe corneal irregularity and thinning.