Intracorneal Ring Segments in Keratoconus: A Narrative Literature Review

Area of Science:

• Ophthalmology
• Corneal Surgery
• Vision Rehabilitation

Background:

• Keratoconus is a progressive corneal ectasia causing irregular astigmatism and high myopia.
• Treatment options include corneal collagen cross-linking (CXL), contact lenses, intracorneal ring segments (ICRS), phakic intraocular lenses, and corneal transplantation.
• Intracorneal ring segments (ICRS) are implants designed to reshape the cornea and improve refractive outcomes.

Purpose of the Study:

• To review the different types of intracorneal ring segments (ICRS) used for keratoconus.
• To explore surgical techniques and emerging developments in ICRS implantation.
• To evaluate the efficacy and safety of ICRS in managing keratoconus.

Main Methods:

• A literature review was conducted using PubMed.
• 117 peer-reviewed manuscripts were analyzed, including reviews, RCTs, case series, and reports.
• Reference lists of publications were also reviewed.

Main Results:

• Various ICRS types exist, including MyoRings, KeraRings, Ferrara Rings, and Intacs.
• Femtosecond laser-assisted tunnel creation improves precision and reduces complications.
• ICRS implantation leads to corneal flattening, astigmatism reduction, and slight corneal stiffening with low complication rates.

Conclusions:

• ICRS are an effective vision enhancement option for select keratoconus patients, potentially avoiding corneal transplants.
• ICRS are particularly useful for contact lens-intolerant patients without central corneal scarring.
• Future research should focus on long-term outcomes and combination therapies like ICRS with CXL.