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Intracorneal ring segment extrusion managed by explantation and corneal tissue replacement: a case report of a novel technique

Poster Details

First Author: T.Baban LEBANON

Co Author(s):    R. Daoud   F. Sammouh   E. Warrak              

Abstract Details

Purpose:

To report a case of intracorneal ring segment (ICRS) extrusion managed by explantation and corneal tissue replacement at the ring site as a trial to maintain ring effect.

Setting:

Saint George Hospital �â�€�“ University Medical Center, Beirut, Lebanon.

Methods:

An 18-year-old healthy female, known to have keratoconus in both eyes treated with ICRS, presented for a regular follow up visit. On presentation, she was found to have ICRS extrusion in the right eye extending 2mm at the temporal edge of the ring. Patient was consequently scheduled for surgical removal. Explantation was done and a donor corneal tissue was used to cut a stromal graft of the same size and shape as the explanted ICRS. The crafted corneal tissue was inserted into the empty ICRS tunnel and fixed in place by 10-0 nylon sutures. Bandage contact lens was placed.

Results:

One week postoperatively, follow up exam revealed a well healed graft with smooth surface. Bandage contact lens and sutures were removed at 3 weeks postop. Preoperatively, the uncorrected visual acuity (UCVA) was 20/200 and best corrected visual acuity (BCVA) was 20/25 (-7.50 Sph �.00 Cyl). The patient maintained an UCVA of 20/200 and BCVA of 20/30 (-8.00 Sph �.75 Cyl) at 3 months postop. Furthermore, preoperative corneal topography showed a Kmax = 52.9D. Topography repeated at 2 weeks and three months postop revealed a constant Kmax of 52.3D.

Conclusions:

We report the successful management of ICRS extrusion by explantation and corneal tissue replacement at the ring site with maintained ring effect and stable vision, refraction and corneal topography.

Financial Disclosure:

NONE

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