First results of myopia correction with intracorneal ring segments (ICRS)

Problem: The implantation of intracorneal ring segments (ICRS) offers the p ossibility of reversible, refractive surgery for correction of lower myopia up to -5.0 D. We report our first results 1 year after implantation of ICR segments. Patients and methods: From April 1997 to August 1998 we implanted ICRS in 4 8 eyes of 31 patients (12 male, 19 female) to correct myopia. The preoperat ive refraction (spherical equivalent) was between -1.0 and -5.0 D (astigmat ism < 1,0 D). The average age was 34,0 years (range 19-48 years). ICRS impl antation was performed in peribulbar anaesthesia. All operations were done by the same surgeon. Results: The average follow-up was 10 months (ranges 1-12 months). After 6 months the deviation from the target refraction of all eyes was < 1.5 D; 26 of 27 eyes (96.3 %) showed a deviation of less than or equal to 1,0 D. Six months after surgery, 18 of 27 eyes (66.6 %) showed an uncorrected visual acuity of 20/20 or better, 23 of 26 eyes (88.4%) showed 20/25 or better, an d 25 of 26 eyes (96.2) 20/40 and better. Only 1 of 16 eyes showed an uncorr ected Visual acuity of 20/50. In all eyes, the best-corrected visual acuity was 20/20 or better. In 2 eyes: an ICRS exchange and implantation of a thi cker ring was necessary because the target refraction could not be achieved with the first implanted ring. In 2 eyes an ICRS reposition was done to op timize the location of the ring within the cornea. In 4 eyes we explanted t he ring due to double vision (1 x) and distorted Vision (3 x) caused by ind uced astigmatism. After explantation the preoperative refraction (+/- 0.15 D) was reached within 1 to 1.5 months. There was no regression after 6 mont hs (n = 27) or after 1 year (n = 7). Conclusion: Our 1-year results of ICRS implantation show that myopia correc tion with the advantage of reversibility and lower complication rate is pos sible by this refractive surgical method. Ring exchange and explantation ar e possible. Earlier postoperative complaints like photophobia, unstable vis ual acuity or discomfort usually disappear rapidly. The decision of 95.0 % of the patients to have ICRS implantation also into the second eye shows th e high degree of satisfaction.