Incidence and associations of intracorneal ring segment explantation.

Purpose: To assess the incidence and motivating determinants of explantation of intracorneal ring segments (ICRS) (Intacs) used for the treatment of keratoconus and corneal ectasia.

Setting: Cornea and refractive surgery subspecialty practice.

Design: Retrospective case series.

Methods: Consecutive cases of ICRS implantation performed to treat keratoconus or corneal ectasia were reviewed to determine the number that were eventually explanted and the motivating factors for explantation. Cases were assigned to 1 of 2 groups: (1) medical complications requiring removal and (2) refractive/topographic problem, with the explantation being elective. The corrected distance visual acuity, uncorrected distance visual acuity, maximum keratometry, and inferior-superior topography power difference before and after ICRS removal were also evaluated.

Results: The ICRS were explanted from 35 eyes of 31 patients from a total cohort of 572 eyes (6.1%). Of these, 15 ICRS (2.6%) were removed for medical complications and 20 (3.5%) for refractive/topographic considerations.

Conclusions: A large proportion of ICRS were generally well tolerated on a long-term basis. The incidence of explantation secondary to medical complications was low, with the most frequent complication being infiltration around the segment. Explantation was effective in ameliorating medical complications and can be effective in improving corneal topography and clinical outcomes in some cases.