title: INTACS followed by KeraRing intrastromal corneal ring segment implantation for keratoconus.
abstract: OBJECTIVE
  To describe the visual and refractive outcomes in three eyes (two keratoconic patients) with previous intrastromal corneal ring segments (INTACS, Addition Technology Inc) that underwent adjuvant single KeraRing (Mediphacos) intrastromal corneal ring segment implantation.
  
  
  METHODS
  Two keratoconic patients (three eyes) with implanted INTACS segments underwent an additional (without explanting previous INTACS) single KeraRing segment implantation.
  
  
  RESULTS
  No intraoperative complications occurred. Six months postoperatively, uncorrected distance visual acuity improved from 20/100 and 20/200 to 20/32 and 20/40 in the right and left eyes, respectively, of patient 1, and from 20/400 to 20/50 in the treated right eye of patient 2. Corrected distance visual acuity improved from 20/50 and 20/100 to 20/30 and 20/32 in the right and left eyes, respectively, of patient 1 and from 20/200 to 20/40 in patient 2. Keratometric measurements improved from 51.00/45.70 to 47.00/44.60 diopters (D) and from 50.80/48.80 to 42.70/40.30 D in the right and left eyes, respectively, of patient 1, and from 49.30/45.70 to 45.60/44.10 D in patient 2.
  
  
  CONCLUSIONS
  In keratoconic patients with INTACS in place, adjuvant single intrastromal corneal ring segment (KeraRing) implantation could improve visual and refractive outcome.
authors.affiliation: Dunya Eye Hospital, Istanbul, Turkey.
authors.forename: Efekan
authors.initials: E
authors.lastname: Coskunseven
authors.forename: George D
authors.initials: GD
authors.lastname: Kymionis
authors.forename: Michael A
authors.initials: MA
authors.lastname: Grentzelos
authors.forename: Alexandra E
authors.initials: AE
authors.lastname: Karavitaki
authors.forename: Dimitra M
authors.initials: DM
authors.lastname: Portaliou
authors.forename: Mirko R
authors.initials: MR
authors.lastname: Jankov
authors.forename: Ebru
authors.initials: E
authors.lastname: Arslan
mesh_terms: D003319:Corneal Stroma / Q000601:surgery*; D019781:Corneal Topography; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012029:Refraction, Ocular / Q000502:physiology; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult