Correction of severe ectasia after LASIK with intracorneal ring segments

PURPOSE: To report a case of severe bilateral ectasia after LASIK that was treated with implantation of small-diameter Keraring intrastromal corneal ring segments (Mediphacos Ltd). METHODS: A 31-year-old woman underwent LASIK in 2001 at a different institution. One year after LASIK, the patient complained of decreased vision in the left eye and underwent LASIK retreatment. Three months after retreatment, uncorrected visual acuity (UCVA) was counting fingers and best spectacle-corrected visual acuity (BSVCA) was 0.4 in the left eye; UCVA was 0.1 and BSCVA was 0.3 in the right eye. Corneal topography showed inferior steepening bilaterally, consistent with ectasia, and the patient was fitted with rigid gas permeable contact lenses. The patient presented to our clinic 4 years after bilateral LASIK with severe loss of BSCVA in both eyes. Examination confirmed the diagnosis of severe bilateral ectasia. The patient underwent implantation of small-diameter Keraring segments assisted by femtosecond laser in June 2005 (left eye) and March 2006 (right eye). RESULTS: Best spectacle-corrected visual acuity improved by four lines in both eyes. Postoperative keratometry showed a decrease of seven diopters in the right eye and nine diopters in the left eye. Postoperative refraction and keratometry have remained stable for 18 and 10 months in the left and right eyes, respectively. CONCLUSIONS: Implantation of intracorneal ring segments can be considered as a treatment option in patients with severe ectasia after LASIK.