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

Hanefi Cakir1, Canan Asli Utine2, Mehmet Baykara31Turkiye Hospital Eye Clinic, Istanbul, 2Department of Ophthalmology, Yeditepe University, Istanbul, 3Department of Ophthalmology, Uludag University, Bursa, TurkeyPurpose: 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 × 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.Conclusion: ICRS implantation with this novel approach may be an option in eyes with severe corneal irregularity and thinning.Keywords: alkali burn, ectasia, intrastromal corneal ring segments