Intracorneal Ring Segments in Keratoconus: A Narrative Literature Review
Usman K Hayat,1,* Haaris A Shiwani,1,* Danyal Memon,2 Andrew Walkden1 1Department of Ophthalmology, Manchester Royal Eye Hospital, Manchester, UK; 2Department of Ophthalmology, The Mater Misericordiae University Hospital, Dublin, Ireland*These authors contributed...
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Dove Medical Press
2025-07-01
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| author | Hayat UK Shiwani HA Memon D Walkden A |
| author_facet | Hayat UK Shiwani HA Memon D Walkden A |
| author_sort | Hayat UK |
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| description | Usman K Hayat,1,* Haaris A Shiwani,1,* Danyal Memon,2 Andrew Walkden1 1Department of Ophthalmology, Manchester Royal Eye Hospital, Manchester, UK; 2Department of Ophthalmology, The Mater Misericordiae University Hospital, Dublin, Ireland*These authors contributed equally to this workCorrespondence: Usman K Hayat, Department of Ophthalmology, Manchester Royal Eye Hospital, Manchester, M13 9WL, UK, Tel +441612761234, Email Usman.Hayat@mft.nhs.ukBackground: Keratoconus is a bilateral, non-inflammatory corneal ectasia characterized by progressive thinning and conical protrusion, leading to irregular astigmatism, usually in association with high myopia. Visual rehabilitation options include corneal collagen cross-linking (CXL), rigid gas permeable contact lenses, intracorneal ring segments (ICRS), phakic intraocular lenses, and corneal transplantation. ICRS are synthetic, biocompatible implants or allogenic corneal tissue, designed to reduce corneal curvature and optimize the refractive profiles. Initially used in 1978 to treat myopia, their role in keratoconus was established in 2000. This review explores ICRS types, surgical techniques, and emerging developments.Methods: A literature review was conducted using PubMed. A total of 117 peer-reviewed manuscripts, including review articles, randomized controlled trials, case series, and reports, were analysed. Reference lists of publications were also reviewed.Results: ICRS types include MyoRings, KeraRings, Ferrara Rings, and Intacs, each with unique design characteristics and implantation methods. Corneal allogenic intrastromal ring segments represent the latest innovation in ICRS. Femtosecond laser-assisted tunnel creation offers improved control over stromal depth and uniformity, reducing complications compared to mechanical dissection. Studies indicate slight corneal stiffening post-ICRS implantation, with no significant changes in intraocular pressure. Topographic changes post-ICRS show significant corneal flattening and reduction in astigmatism. Complications include epithelial defects, segment migration, and keratitis, but long-term follow-up reveals low rates of serious adverse events.Conclusion: ICRS provide an effective option for enhancing vision in select keratoconus patients, ultimately lowering the chances of requiring a corneal transplant. They are of particular use in those intolerant to contact lenses and without central corneal scarring. Future research should focus on long-term outcomes. Combining ICRS with other procedures like CXL may enhance outcomes, though careful patient selection is crucial.Keywords: Intracorneal ring segments, keratoconus |
| format | Article |
| id | doaj-art-dfa96965dd5d4cd6a4b72fe552997f87 |
| institution | OA Journals |
| issn | 1177-5483 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Ophthalmology |
| spelling | doaj-art-dfa96965dd5d4cd6a4b72fe552997f872025-08-20T02:37:09ZengDove Medical PressClinical Ophthalmology1177-54832025-07-01Volume 19Issue 122492257104708Intracorneal Ring Segments in Keratoconus: A Narrative Literature ReviewHayat UK0Shiwani HA1Memon D2Walkden A3Department of OphthalmologyDepartment of OphthalmologyDepartment of OphthalmologyDepartment of OphthalmologyUsman K Hayat,1,* Haaris A Shiwani,1,* Danyal Memon,2 Andrew Walkden1 1Department of Ophthalmology, Manchester Royal Eye Hospital, Manchester, UK; 2Department of Ophthalmology, The Mater Misericordiae University Hospital, Dublin, Ireland*These authors contributed equally to this workCorrespondence: Usman K Hayat, Department of Ophthalmology, Manchester Royal Eye Hospital, Manchester, M13 9WL, UK, Tel +441612761234, Email Usman.Hayat@mft.nhs.ukBackground: Keratoconus is a bilateral, non-inflammatory corneal ectasia characterized by progressive thinning and conical protrusion, leading to irregular astigmatism, usually in association with high myopia. Visual rehabilitation options include corneal collagen cross-linking (CXL), rigid gas permeable contact lenses, intracorneal ring segments (ICRS), phakic intraocular lenses, and corneal transplantation. ICRS are synthetic, biocompatible implants or allogenic corneal tissue, designed to reduce corneal curvature and optimize the refractive profiles. Initially used in 1978 to treat myopia, their role in keratoconus was established in 2000. This review explores ICRS types, surgical techniques, and emerging developments.Methods: A literature review was conducted using PubMed. A total of 117 peer-reviewed manuscripts, including review articles, randomized controlled trials, case series, and reports, were analysed. Reference lists of publications were also reviewed.Results: ICRS types include MyoRings, KeraRings, Ferrara Rings, and Intacs, each with unique design characteristics and implantation methods. Corneal allogenic intrastromal ring segments represent the latest innovation in ICRS. Femtosecond laser-assisted tunnel creation offers improved control over stromal depth and uniformity, reducing complications compared to mechanical dissection. Studies indicate slight corneal stiffening post-ICRS implantation, with no significant changes in intraocular pressure. Topographic changes post-ICRS show significant corneal flattening and reduction in astigmatism. Complications include epithelial defects, segment migration, and keratitis, but long-term follow-up reveals low rates of serious adverse events.Conclusion: ICRS provide an effective option for enhancing vision in select keratoconus patients, ultimately lowering the chances of requiring a corneal transplant. They are of particular use in those intolerant to contact lenses and without central corneal scarring. Future research should focus on long-term outcomes. Combining ICRS with other procedures like CXL may enhance outcomes, though careful patient selection is crucial.Keywords: Intracorneal ring segments, keratoconushttps://www.dovepress.com/intracorneal-ring-segments-in-keratoconus-a-narrative-literature-revie-peer-reviewed-fulltext-article-OPTHIntracorneal ring segmentskeratoconus |
| spellingShingle | Hayat UK Shiwani HA Memon D Walkden A Intracorneal Ring Segments in Keratoconus: A Narrative Literature Review Clinical Ophthalmology Intracorneal ring segments keratoconus |
| title | Intracorneal Ring Segments in Keratoconus: A Narrative Literature Review |
| title_full | Intracorneal Ring Segments in Keratoconus: A Narrative Literature Review |
| title_fullStr | Intracorneal Ring Segments in Keratoconus: A Narrative Literature Review |
| title_full_unstemmed | Intracorneal Ring Segments in Keratoconus: A Narrative Literature Review |
| title_short | Intracorneal Ring Segments in Keratoconus: A Narrative Literature Review |
| title_sort | intracorneal ring segments in keratoconus a narrative literature review |
| topic | Intracorneal ring segments keratoconus |
| url | https://www.dovepress.com/intracorneal-ring-segments-in-keratoconus-a-narrative-literature-revie-peer-reviewed-fulltext-article-OPTH |
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