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

Abstract

PurposeTo report the use of intracorneal ring segment (ICRS) implantation in a case of severe corneal thinning and irregularity secondary to alkali burn.Case reportA 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 × 180°). Orbscan II® revealed steepening of >53 D superiorly, excessive thinning inferiorly with thinnest pachymetric reading of 269 μm. Two KeraRing® segments, 200 μm thick and 90° arced, were implanted. During intrastromal channel creation by Intralase®, 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 × 35°). Visante® opticial coherence tomography displayed ICRS at a depth of <370 μm.ConclusionICRS implantation with this novel approach may be an option in eyes with severe corneal irregularity and thinning.