Successful Management Of A Dislocated Corneal Ring Segment In Patient With Keratoconus

Keratoconus is a progressive corneal disorder that can lead to visual improvement. Corneal ring segment (CRS) implantation is a common treatment for moderate to advanced keratoconus to improve visual acuity and corneal stability. However, complications such as dislocation of the CRS may arise, requiring surgical intervention.

This report highlights the importance of careful monitoring of CRS patients, prompt recognition of complications and potential for visual improvement following surgical intervention and ring removal.

The case was managed in a specialized ophthalmology clinic with advanced diagnostic tools, including slit-lamp biomicroscopy. The surgery was performed in an operating room under local anesthesia, following standard antiseptic protocols. Post-operative care was provided on an outpatient basis with regular follow-ups.

Case Presentation: A 45-year-old female with a history of CRS implantation in both eyes for stage 3 keratoconus in 2023 presented with discomfort, excessive tearing, and a mild decrease in visual acuity (VA = 0.5) in the left eye. Six months prior, the patient had vigorously rubbed her eye, leading to the displacement of the CRS. Slit-lamp examination revealed a dislocated CRS in the left eye. Given the discomfort and instability, the decision was made to remove the CRS.

Surgical Intervention: The CRS was successfully removed, revealing a deep, open tunnel in the cornea. The surface was irrigated with antiseptics, and a therapeutic contact lens was placed. Post-operative care included one week of antibiotic and moisturizing eye drops to support healing and prevent infection.

Outcome: The tunnel healed with epithelialization, and the eye remained free of irritation or inflammation. Visual acuity remained stable at 0.5 post-surgery. Six months of follow-up showed no visual acuity or ocular health deterioration, and the eye remained clear without further complications.

Conclusion: This case highlights the successful management of a dislocated CRS in a patient with keratoconus. The removal of the dislocated CRS, followed by epithelial healing and appropriate post-operative care, resulted in stable visual acuity and a healthy cornea.