Keratoconic eye experience with a long-arc intrastromal corneal ring
Long-arc ICRS were developed to meet the needs of patients with nipple-type keratoconus. However, new study findings suggest they may also help to improve visual acuity and regularise the cornea in patients with all types of keratoconus.
Until quite recently, patients with keratoconus faced a somewhat bleak future. Patients whose vision could no longer be managed with spectacles and rigid contact lenses typically faced highly invasive penetrating or lamellar keratoplasty and the side effects and postoperative complications associated with these procedures.
Thankfully, this is no longer the case. There are now several treatment options available including toric phakic IOLs, collagen corneal crosslinking, topo-guided photorefractive keratectomy (PRK) and intrastromal corneal ring segments (ICRS). Although some patients may still eventually require a corneal transplant, these treatment modalities can at least delay, if not negate, the need for keratoplasty.
In patients with early-stage keratoconus, ICRS implantation can help to improve visual acuity by decreasing irregular astigmatism and reducing corneal steepening.1 ICRS are appealing to both surgeons and patients because the surgery required is minimally invasive and because they can be removed or repositioned if necessary. Importantly, they can be successfully combined with other treatments such as corneal crosslinking and PRK in patients with more advanced keratoconus, which can optimise the effects of the ICRS.2-6
Although ICRS may be associated with complications such as incomplete channel creation and postoperative segment migration, I regard it as a core treatment in the management of keratoconus.
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