Wavefront-guided Photorefractive Keratectomy for Correction of Residual Refractive Error after Intacs Implantation in Patients with Keratoconus

Purpose: To evaluate the efficacy of Wavefront-guided photorefractive keratectomy (PRK) for correction of residual refractive error after intrastromal corneal ring segments (ICRS) insertion for treatment of keratoconus. Patients and Methods: In this prospective case series five eyes of 5 keratoconus patients who had previous ICRS implantation (four Intacs TM and one Keraring), underwent Wavefront-guided PRK to correct residual refractive error. Results: Three months postoperatively, the mean spherical equivalent (SE) improved from 2.07 ± 1.38 Diopter to - 0.87 ± 0.54 Diopter. Four out of 5 eyes were within ± 1.00 D of Plano refraction. Three eyes had UCVA of 20/30 or better (all eyes; 20/40 or better). After 6 months, the mean SE was - 0.75 ± 0.50 Diopter and all eyes were within ± 1.00 D of Plano refraction. UCVA was 20/20 in 2 eyes, 20/30 or better in 2 eyes and 20/40 in one eye. One patient lost one line of BCVA. Conclusion: This case series showed that wavefront-guided PRK might be an effective procedure for correction of residual refractive error after ICRS insertion in keratoconus patients. Significant improvement in UCVA was seen in all cases after PRK without any complications and haze.