2020–2021 BCSC Basic and Clinical Science Course™
13 Refractive Surgery
Chapter 4: Onlays and Inlays
Intrastromal Corneal Ring Segments
Ectasia After LASIK
Ring segments have also been used for the postoperative management of corneal ectasia after LASIK. As in the treatment of keratoconus, few surgical options are available to treat corneal ectasia. Use of an excimer laser to remove additional tissue is generally considered contraindicated. A lamellar graft or penetrating keratoplasty may result in significant morbidity, such as irregular astigmatism, delayed recovery of vision, and tissue rejection. In limited early trials that used Intacs to treat post-LASIK ectasia, myopia was reduced and UCVA was improved. However, the long-term effect of such an approach for managing post-LASIK ectasia is still being evaluated. Use of Intacs for post-LASIK ectasia is an off-label treatment, and care should be taken with implantation in the presence of a lamellar interface.
Kymionis GD, Tsiklis NS, Pallikaris AI, et al. Long-term follow-up of Intacs for post-LASIK corneal ectasia. Ophthalmology. 2006;113(11):1909–1917.
Rabinowitz Y. INTACS for keratoconus and ectasia after LASIK. Int Ophthalmol Clin. 2013; 53(1):27–39.
Excerpted from BCSC 2020-2021 series: Section 13 - Refractive Surgery. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.