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Femtosecond-assisted MyoRing after failed intracorneal ring segments in keratoconus: one step surgery

Poster Details

First Author: M.Ismail EGYPT

Co Author(s):    H. Rashed                    

Abstract Details


To determine the efficacy of femtosecond (FS) laser in dissecting a pocket at the level of previously implanted intracorneal ring segments (ICRS), thus facilitating their removal and implantation of a MyoRing.


Al Azhar University, Cairo, Egypt , Ain Shams University, Cairo, Egypt


This study included 26 eyes with manually implanted Ferrara ICRS with unfavorable outcome, defined as an increase in mean K of 1 dopter or more or a loss of 2 lines of BSCVA. In each of these eyes FS dissection of a circular pocket 9 mm in diameter was done at the same depth of the implanted ICRS, explantation of the ICRS was done and directly followed by insertion of the Myoring according to its nomogram. Postoperative follow up was done at months 1, 3, and 6, during wchich recording of BSCVA and mean K were done.


FS laser could successfully dissect a pocket at the level of the previously implanted ICRS and go around and outside the ICRS with ease, thus facilitating its exchange with a MyoRing. Mean preoperative BSCVA (logMAR) before implantation was 0.38 ± 0.24; at final follow-up examination BSCVA was 0.22 ± 0.9, P = 0.008. Mean K decreased from 50.34 to 44.56 D, P < 0.001. All patients were satisfied with MyoRing implantation. No intraoperative or postoperative complications were demonstrated.


This preliminary study shows that simultaneous FS assisted ICRS explantation and MyoRing implantation is an efficient, safe, and minimally invasive procedure in keratoconic eyes.

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