title: Intacs Followed by MyoRing Implantation in Severe Keratoconus.
abstract: OBJECTIVE
  To describe the outcome of complete intrastromal ring (MyoRing, DIOPTEX GmBH, Linz, Austria) implantation following intrastromal corneal ring segment (Intacs, Addition Technology, Inc., Sunnyvale, CA) implantation for severe keratoconus.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A MyoRing was implanted in a keratoconic patient who had undergone a previous Intacs implantation surgery 4 years previously without Intacs explantation and had residual refractive error. There were no intraoperative or postoperative complications. After 1 year; mean keratometric power decreased from 50.3 to 43.6 diopters, uncorrected distance visual acuity improved from 20/400 to 20/50, and corrected distance visual acuity improved from 20/200 to 20/30.
  
  
  CONCLUSIONS
  In selected severe keratoconus cases with high myopia and steep keratometry previously treated with Intacs implantation, if significant residual refractive error is observed, secondary implantation of MyoRing over Intacs may improve vision and refraction.
authors.affiliation: Ophthalmology Research center, Tehran University of Medical Sciences, Farabi Eye Hospital, Teheran, Iran.
authors.forename: Mahmoud Jabbarvand
authors.initials: MJ
authors.lastname: Behrouz
authors.forename: Hesam
authors.initials: H
authors.lastname: Hashemian
authors.forename: Mehdi
authors.initials: M
authors.lastname: Khodaparast
authors.forename: Ahmad Salamat
authors.initials: AS
authors.lastname: Rad
authors.forename: Mahla
authors.initials: M
authors.lastname: Shadravan
mesh_terms: D000328:Adult; D063171:Corneal Pachymetry; D003319:Corneal Stroma / Q000601:surgery*; D019781:Corneal Topography; D006801:Humans; D007640:Keratoconus / Q000601:surgery*; D008297:Male; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012029:Refraction, Ocular / Q000502:physiology; D012030:Refractive Errors / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology