According to a recent study, implanting an additional intrastromal corneal ring segment in keratoconus patients with previous implants may enhance final visual and refractive outcomes.

Researchers implanted the KeraRing (Mediphacos) intrastromal corneal ring segment in five eyes of three patients without removing previously implanted Intacs (Addition Technology) segments. They then compared Snellen uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive and keratometric values from before and after the additional implant.

In four of the five eyes, UDVA, CDVA, subjective refraction and keratometric values improved and remained stable at a 36-month median follow-up. Additionally, total higher-order aberrations showed improvement in all cases. One case of glare under scotopic conditions was the only reported complication.

“This method could be a viable option, especially in patients with small scotopic pupils, to obtain better results in the case of unacceptable outcomes after the first ICRS placement,” the study concluded. “However, it should be compared with other alternatives including exchanging the ring and laser ablation in future studies.”

Hashemi H, Nabavi A, Bayat R, Mohebbi M. Additional intrastromal corneal ring segments in keratoconus. Cornea. 2018;37(5):574-9.