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Intracorneal Ring Segment Explantation After Intracorneal Ring Segment Implantation Combined With Same-Day Corneal Collagen Crosslinking in Keratoconus

Yeung, Sonia N. MD, PhD, FRCSC; Lichtinger, Alejandro MD; Ku, Judy Y. F. MBBS, FRANZCO; Kim, Peter MBBS (Hons), FRANZCO; Low, Stephanie A. W. BHsc; Rootman, David S. MD, FRCSC

doi: 10.1097/ICO.0b013e3182a738ba
Case Report

Purpose: To report the outcome and the reversibility of refractive outcomes after intrastromal corneal ring segment (ICRS) explantation in patients with keratoconus treated with ICRS implantation and same-day collagen crosslinking (CXL).

Methods: This is a retrospective review of ICRS explantation in 3 eyes of 3 patients with keratoconus that had undergone femtosecond laser–enabled placement of paired ICRS (Intacs) with same-day CXL by a single surgeon between 2008 and 2011. The main outcome measures included baseline/preexplantation/postexplantation visual acuity, refractive error, keratometry, and higher order aberrations.

Results: None of the patients lost best-corrected distance visual acuity lines. ICRS can be safely and easily explanted from keratoconic eyes with previous CXL. Some of the topographic benefits gained from ICRS implantation may persist after explantation.

Conclusions: Despite the reversal of refractive outcomes, the preservation of topographic changes may occur in some cases after the explantation of 1 or both the segments in patients with keratoconus treated with ICRS implantation with same-day CXL.

*Yonge Eglinton Laser Eye Center, Toronto, Ontario, Canada; and

Department of Ophthalmology, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.

Reprints: Sonia N. Yeung, Department of Ophthalmology, Toronto Western Hospital, East Wing 6-401, 399 Bathurst St, Toronto, Ontario M5T 2S8, Canada (e-mail:

The authors have no funding or conflicts of interest to disclose.

Received May 20, 2013

Accepted July 27, 2013

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.