High post-penetrating keratoplasty astigmatism can be mitigated using specialized intrastromal corneal ring segment implants

• DOI: 10.4103/ijo.ijo_3190_22
• Publication Date: 2023-12-22T06:03:00Z
• Authors: Roberto Albertazzi; Carlos Rocha-de-L...; Leonardo Ferlini; Franco A Perrone
• Keywords: Astigmatism

Dear Editor, Postoperative astigmatism is a common complication that occurs after penetrating keratoplasty (PK) or deep anterior lamellar keratoplasty, with over one-fifth of the patients developing >5 diopters (D) astigmatic error postoperatively.[1] Arriola-Villalobos et al.[2] reported implantation 5-mm diameter intrastromal corneal ring segments (ICRS) may be optimal for correcting high PK. Recently, finite element simulation study demonstrated use an 800-µm base while maintaining same thickness resulted in strongest peripheral and central flattening.[3] Our group retrospectively reviewed clinical outcomes special ICRS model, 800 µm apical 5 mm, was solicited produced by Mediphacos (Belo Horizonte, Brazil) 20 years ago, selected keratoconus PK [Fig. 1], private clinic Quilmes (Buenos Aires, Argentina) between 2002 2019. Data 12 eyes 11 are presented Table 1. Their mean topographic 12.9 ± 3.8 D (6.9–19.6) at baseline, which decreased (P < 0.001) to 4.2 2.3 (0.4–8.8) implantation. The baseline UDVA 1.00 0.21 LogMAR (0.6–1.3), whereas postoperative UCVA 0.32 0.17 (0.1–0.7). CDVA 0.63 0.15 (0.2–0.8), 0.12 0.05 (0–0.2).Figure 1: (a) Slit-lamp image showing two implanted patient's post-penetrating eye. (b) Anterior-segment OCT slit-lamp images without fluorescein eye one implanted. PK, keratoplasty; ICRS, segments; OCT, ophthalmic coherence tomographyTable Description cases underwent managing residual astigmatismThe post-PK history improved implanting base-width ICRS. Refractive stability achieved least 2 postoperatively, complications were not detected. model currently commercially available, present, there still none characteristics. In view need develop commercial models similar characteristics, our data available both readers industry. Financial support sponsorship: Nil. Conflicts interest: There no conflicts interest.