title: Implantation of new intracorneal ring segments after segment explantation for unsuccessful outcomes in eyes with keratoconus.
abstract: OBJECTIVE
  To evaluate the visual, refractive, and corneal aberrometric outcomes in eyes with keratoconus that had implantation of new intracorneal ring segment (ICRS) after previous segment explantation for an unsuccessful outcome.
  
  
  METHODS
  Vissum Corporation, Alicante, Spain.
  
  
  METHODS
  This retrospective nonrandomized case series included consecutive eyes of patients ranging in age from 18 to 64 years. All cases had an initial diagnosis of keratoconus and had ICRS implantation to manage corneal irregularity. In all cases, the initial ICRS were explanted because of an unsuccessful outcome (eg, segment extrusion, poor visual outcomes) and a new ICRS combination was implanted subsequently. A complete ophthalmic examination was performed in all eyes before and 1 month after initial ICRS implantation, before ICRS explantation, and 1 month and 6 months after implantation of the new ICRS.
  
  
  RESULTS
  Twenty-one eyes (21 patients) were evaluated. There was a significant improvement in uncorrected distance visual acuity (P = .03) and thus a significant improvement in manifest refraction 1 month after implantation of the new ICRS (P</=.04). There was a statistically significant difference in keratometry readings (P</=.01) and a significant improvement in corneal aberrometry (P</=.03) between preoperatively and 6 months after the second surgery. There were no statistically significant differences in any visual, refractive, keratometric, or aberrometric parameter between eyes that had ICRS explantation for segment extrusion and eyes that had explantation for poor visual outcomes (P>/=.07).
  
  
  CONCLUSIONS
  Significant visual and refractive improvements were achieved by implanting a new ICRS combination after previous unsuccessful ICRS implantation.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain. jlalio@vissum.com
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Alió
authors.forename: David P
authors.initials: DP
authors.lastname: Piñero
authors.forename: Esin
authors.initials: E
authors.lastname: Söğütlü
authors.forename: Anil
authors.initials: A
authors.lastname: Kubaloglu
mesh_terms: D057128:Aberrometry; D000293:Adolescent; D000328:Adult; D003319:Corneal Stroma / Q000601:surgery*; D019781:Corneal Topography; D020878:Device Removal; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D011475:Prosthesis Failure; D019919:Prosthesis Implantation; D012029:Refraction, Ocular / Q000502:physiology; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult