title: Refractive and topographic fluctuations due to intracorneal ring segments motility.
abstract: OBJECTIVE
  To describe a patient with refractive and topographic fluctuations 5 years after intracorneal ring segments (ICRS) implantation for the management of corneal ectasia after LASIK.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A 48-year-old woman presented complaining of intermittent decreased vision over 1 year that improved with eye rubbing. Slit-lamp and optical coherence tomography (OCT) examinations revealed overriding ring segments that could be restored to normal position after minor corneal massage. Topographic and refractive findings were significantly influenced by the ICRS positioning and caused decreased visual function when overriding. To avoid ICRS override, surgical dissection of the corneal tunnel along with ring segment repositioning was performed. A suture was placed through the ring's positioning hole to stabilize the ICRS at its optimal position and to avoid recurrence of this phenomenon.
  
  
  CONCLUSIONS
  Patients undergoing femtosecond laser-assisted ICRS implantation may experience ring segment migration and override of the segments that could lead to decreased visual function. Proper surgical repositioning and ring segment fixation may address this complication and offer satisfactory visual and refractive outcomes along with avoidance of ICRS migration and override.
authors.forename: Vasilios F
authors.initials: VF
authors.lastname: Diakonis
authors.forename: Vardhaman P
authors.initials: VP
authors.lastname: Kankariya
authors.forename: Fasika
authors.initials: F
authors.lastname: Woreta
authors.forename: Sonia H
authors.initials: SH
authors.lastname: Yoo
authors.forename: Jordon G
authors.initials: JG
authors.lastname: Lubahn
authors.forename: George D
authors.initials: GD
authors.lastname: Kymionis
authors.forename: Lana
authors.initials: L
authors.lastname: Srur
mesh_terms: D003319:Corneal Stroma / Q000601:surgery*; D019781:Corneal Topography; D005260:Female; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007640:Keratoconus / Q000209:etiology / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects; D008875:Middle Aged; D009216:Myopia / Q000601:surgery; D019904:Polymethyl Methacrylate; D019736:Prostheses and Implants / Q000009:adverse effects*; D019919:Prosthesis Implantation; D012030:Refractive Errors / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D041623:Tomography, Optical Coherence; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology
chemical_list: D019904:Polymethyl Methacrylate