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Mild/high myopia correction with intrastromal ring followed by PRK in patients with post-refractive surgery ectasia risk

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Session Details

Session Title: Primary and Secondary Ectasia

Session Date/Time: Sunday 23/09/2018 | 08:00-10:00

Paper Time: 08:42

Venue: Room A4

First Author: : P.Rodrigues BRAZIL

Co Author(s): :    S. Coscarelli   J. Gomes   D. Freitas   F. Moura           

Abstract Details


The main purpose is to quantify the refractive and corneal topographic changes induced by the implantation of two types of ICRS in myopic patients with risk of refractive ectasia followed by PRK after 6 months of the first surgery. As a secondary purpose, to evaluate the refractive predictability of the excimer laser on the new surgical stromal bed after ICRS implantation.


Clínica de Olhos Enio Coscarelli and Federal University of São Paulo - Brasil


• Group 1: One pair of 155º/200µ rings with 5.5mm ZO (optical zone) (Cornealring, Brazil). • Group 2: 340º/200µ segment with 5.0mm ZO (Mediphacos, Brazil); The goal is myopic reduction respecting to manufacturer’s nomogram. After 6 months, PRK (SCHWIND, Germany) with 5.5mm ZO and 5.0 mm ZO respectively were performed using residual dynamic refraction and 0.002% MMC for 30 seconds. Data were collected after 6 months of each procedure. criteria Age between 18 and 35 years; Spherical equivalent up to -12D and stable refraction for one year; No previous surgery and/or any ocular pathology; Central pachymetry less than 500µ.


35 eyes of 18 patients underwent surgeries between August 2016 and August 2017 with follow up of 7 months. The mean age was 25.85 years (range 18-35 years) with mean spherical equivalent (Eq.Esf) of -6.3D previous reaching -2.44D after icrs and + 0.29D after PRK in group 1 (27 eyes ). Group 2 (8 eyes) had Eq.Esf of -7.12D reaching -3.62D after icrs and + 0.93D after PRK. The patients maintained the BCVA of 0.16 Logmar (table 1). Only 03 eyes presented haze after 1 year.


Low visual acuity can have a profound impact on quality of life and psychological well-being. The surgical combination of ICRS and complementary PRK for myopic correction in this patient profile proved to be safe allowing good visual acuity, independent of optical media. It is believed that the discreet final hypercorrection obtained has a greater relation "with large-segment ICRS (which act as a new "surgical limbus"). This study approaches the possibility of a new treatment perspective for a specific group of patients taking into account the reversible. New procedures should be performed with the focus of improving the technique.

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