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Intrastromal Corneal Ring Segment Implantation for Early Keratoconus

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Keratoconus

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Abstract

In the last two decades, the widespread use of corneal tomography and the growing attention to risk factors like eye allergies, eye rubbing, sleeping on the eyes, and others have turned into game changers when evaluating patients with keratoconus.

Meanwhile, the dissemination of femtosecond laser devices and the development of new innovative treatment options have constituted huge advances in the therapeutics of the disease. In the case of intrastromal ring segments, for a growing number of corneal specialists, their implantation has been converted into the most simple, effective, and safest option to treat symptomatic keratoconus patients with contact lens intolerance. With the spreading of this technique, refinement of results has followed, driven by attentive manufacturers committed to improve the technology by presenting new segment options and nomograms more directed to face different subtypes of ectasia, which, in a virtuous circle, fed an increase on its popularity. It was in this collaborative environment between industry, researchers, and surgeons that intrastromal segments have started being used in more challenging cases like the less symptomatic and more demanding patients with early ectasia.

This chapter starts with an analysis of different therapeutic approaches used in early keratoconus. Next, essential aspects of the implantation of intrastromal segments on this specific population are discussed in relation to the patient, the surgeon, the surgical planning, and the effects on visual acuity, ametropia, and optical aberrations. The stabilization of ectasia, the possibility of reoperations, the reversibility of intervention, additional procedures, and related adverse effects are also examined.

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Authors and Affiliations

  1. Cornea Center Clinic, Porto Alegre, RS, Brazil

    Daniel Fridman

  2. Corneal Transplantation Team, Eye Bank Hospital, Porto Alegre, RS, Brazil

    Daniel Fridman

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  1. Daniel Fridman
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Editors and Affiliations

  1. Provisão Eye Hospital of Maringá, Maringá, Paraná, Brazil

    Edna Almodin

  2. Federal University of São Paulo, São Paulo, São Paulo, Brazil

    Belquiz Amaral Nassaralla

  3. Nucleo de Medicina Ocular, Goiânia, Goiás, Brazil

    Jordana Sandes

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Fridman, D. (2022). Intrastromal Corneal Ring Segment Implantation for Early Keratoconus. In: Almodin, E., Nassaralla, B.A., Sandes, J. (eds) Keratoconus . Springer, Cham. https://doi.org/10.1007/978-3-030-85361-7_60

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