Keratitis after Implantation of Intrastromal Corneal Rings with Spontaneous Extrusion of the Segment

Purpose: To report a case of bacterial keratitis in a patient with a history of intrastromal corneal ring segments (INTACS®) implantation to correct keratoconus. Methods: The patient’s history, clinical presentation, pathological analysis and therapeutic management were reviewed. Results: A 36-year-old-man was referred to our department due to decreased vision and intense pain in his left eye, 40 days after INTACS® implantation for keratoconus. Slit-lamp examination revealed epithelial defects and stromal infiltrates in the lower channel without evidence of the inferior ring. The anterior chamber also showed a significant fibrin reaction to hypopyon. A low-tension suture was removed at the site of the incision. Microbiological study of the conjunctival swab was positive for Staphylococcus epidermidis, but the corneal culture was sterile. The patient was treated with topical fortified and systemic antibiotics. The infection slowly resolved, leaving opacity at the inferior segment site. Conclusions: Infectious keratitis following INTACS implantation is an infrequent complication that can have important consequences without suitable and early therapeutic management.