Unexpected visual improvement after aborted intracorneal ring segment implantation for keratoconus.

Area of Science:

• Ophthalmology
• Corneal Surgery
• Refractive Surgery

Background:

• Keratoconus is a progressive corneal ectasia leading to irregular astigmatism and visual impairment.
• Intracorneal ring segments (ICRS) are used to regularize the corneal surface and improve visual acuity in keratoconus patients.
• Femtosecond laser technology offers precise corneal incisions for refractive procedures.

Observation:

• A case report details a 25-year-old female patient with keratoconus undergoing femtosecond laser-assisted ICRS implantation in her right eye.
• The ICRS implantation procedure was aborted due to technical difficulties.
• Anterior segment imaging revealed a full-thickness corneal incision with microperforation post-procedure.

Findings:

• Despite the aborted implantation, the patient experienced significant visual acuity improvement.
• Keratometric findings ameliorated, leading to a more regular corneal shape.
• These visual and keratometric improvements were sustained at the 6-month postoperative follow-up.

Implications:

• This case suggests that femtosecond laser-created full-thickness corneal incisions, even without ICRS implantation, may unexpectedly improve keratometric and visual outcomes in keratoconus.
• The creation of an intracorneal tunnel alone, combined with the corneal incision, might contribute to corneal regularization.
• Further research is warranted to explore the therapeutic potential of femtosecond laser corneal incisions in keratoconus management.