Photorefractive keratectomy after intratromal corneal ring egment explantation

PURPOE: To decribe a cae of photorefractive keratectomy after removal of intratromal corneal ring egment from the cornea. METHOD: During United tate Food and Drug Adminitration Phae III Trial for intratromal corneal ring egment (ICR), the implanted egment were removed from the cornea of the right eye of a patient becaue of diatifaction with glare, halo, and fluctuating viion. Ten month after ICR explantation, the patient underwent a photorefractive keratectomy procedure to the ame eye. REULT: One month after removal of the ICR, the patient’ manifet refraction wa within ±0.50 diopter of hi original manifet refraction. Photorefractive keratectomy wa planned to the ame eye 6 month later. At the firt attempt, the epithelium could not be removed with the laer and crape technique, and reidual epithelium wa noted at the vertical meridian (12 o’clock) corneal inciion ite, which had been ued for ICR urgery and explant; therefore, the procedure wa aborted. At the econd attempt, with a mechanical epithelial bruh (AMOIL Epithelial crubber; Innova, Inc, Toronto, Canada), the epithelium wa removed with eae. After thi, photorefractive keratectomy wa done without difficulty or complication. At hi mot recent 8-month potphotorefractive keratectomy examination, the patient had an uncorrected viual acuity of RE: 20/16, with a manifet refraction of −0.75 to 0.75 × 170 degree, a faint haze at the ite of the tromal channel, and a mall car at the inciion ite on lit-lamp examination. CONCLUION: Intratromal corneal ring egment can be readily removed from the cornea, if required. In thi cae, the refraction returned to it preoperative tate oon after the explant procedure and remained table over time. Photorefractive keratectomy wa performed a a econdary refractive urgical procedure after the removal of ICR without difficulty or complication. However, removal of the epithelium i probably bet accomplihed with the ue of an epithelial bruh, conidering the change in the epithelial adherence in a poturgical cornea. Further tudie are required to etablih the afety and efficacy of econdary refractive urgical procedure after ICR explantation