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Asia Pac J Ophthalmol (Phila). 2012 Nov-Dec;1(6):327-30. doi: 10.1097/APO.0b013e31826e1d30.

Intracorneal Ring Segment Reimplantation in Keratectasia.

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From the *Vision Eye Institute, Chatswood; †Faculty of Science, University of New South Wales; and ‡Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.



The objective of this study was to evaluate the safety and potential for visual improvement of replacing INTACS with Kerarings in patients with keratectasia.


Retrospective case series.


A review of patients undergoing intracorneal segment exchange was conducted. Ten eyes of 9 patients that underwent INTACS explantation and Keraring re-implantation were included. Visual acuity, manifest refraction, keratometry, and corneal asphericity readings were collected. Data were analyzed preoperatively, immediately before Keraring insertion, and at 3, 6, and 12 months after Keraring implantation.


The mean age of subjects was 44.5 ± 11.23 years. The mean time to exchange was 13.9 ± 9.8 months. The initial indications for surgery were post- Laser-Assisted in Situ Keratomileusis ectasia (n = 6) and keratoconus (n = 4). The removal and re-implantation procedure were successfully completed in all eyes without significant complications. No statistical difference was observed with respect to keratometry readings, manifest sphere, and manifest cylinder during follow-up. There was a significant improvement in mean decimal corrected distance visual acuity at 3, 6, and 12 months after Keraring insertion (P>0.05). The Q values were -0.37 ± 0.94 after INTACS implantation and -0.18 ± 0.62, 0.06 ± 0.31, and 0.00 ± 0.38 at 3, 6, and 12 months after insertion of Kerarings.


Replacement of INTACS with Kerarings appears to be a safe procedure and may lead to an increase in corrected distance visual acuity in some eyes. This may be related to the change in corneal asphericity as experienced by our cohort.

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