Intrastromal corneal ring segment

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Intrastromal corneal ring segment
IntacsAfterInsertion.jpg
A pair of corneal rings after insertion into the cornea
Other namesIntrastromal corneal ring
Specialty ophthalmology

An intrastromal corneal ring segment (ICRS) (also known as intrastromal corneal ring, corneal implant or corneal insert) is a small device surgically implanted in the cornea of the eye to correct vision. Two crescent or semi-circular shaped ring segments are inserted between the layers of the corneal stroma, one on each side of the pupil, [1] This is intended to flatten the cornea and change the refraction of light passing through the cornea on its way into the eye.

Contents

Design

Intrastromal corneal ring segments have many different types and designs. Manufacturers include Intacs (US), Cornealring (Brazil), Mediphacos Keraring (Brazil), [2] Ferrara ring (Brazil), [3] Myoring (Austria) [4] and Intraseg (UK).

Medical uses

Intrastromal corneal rings were originally used to treat mild myopia. [1] For this purpose, they have largely been superseded by excimer lasers, which have better accuracy. [1] They are now mostly used to treat mild to moderate keratoconus. [1] Intrastromal corneal rings were approved in 2004 by the Food and Drug Administration for people with keratoconus who cannot adequately correct their vision with glasses or contact lenses, and for whom corneal transplant is the only other option. [5] They were approved under the Humanitarian Device Exemption, [3] [6] which means the manufacturer did not have to demonstrate effectiveness. According to the FDA, these products should not be used by people who "can achieve functional vision on a daily basis using contact lenses." [5]

Related Research Articles

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<span class="mw-page-title-main">Keratoconus</span> Medical condition involving the eye

Keratoconus (KC) is a disorder of the eye that results in progressive thinning of the cornea. This may result in blurry vision, double vision, nearsightedness, irregular astigmatism, and light sensitivity leading to poor quality-of-life. Usually both eyes are affected. In more severe cases a scarring or a circle may be seen within the cornea.

<span class="mw-page-title-main">LASIK</span> Corrective ophthalmological surgery

LASIK or Lasik, commonly referred to as laser eye surgery or laser vision correction, is a type of refractive surgery for the correction of myopia, hyperopia, and an actual cure for astigmatism, since it is in the cornea. LASIK surgery is performed by an ophthalmologist who uses a laser or microkeratome to reshape the eye's cornea in order to improve visual acuity.

<span class="mw-page-title-main">Refractive surgery</span> Surgery to treat common vision disorders

Refractive surgery is optional eye surgery used to improve the refractive state of the eye and decrease or eliminate dependency on glasses or contact lenses. This can include various methods of surgical remodeling of the cornea (keratomileusis), lens implantation or lens replacement. The most common methods today use excimer lasers to reshape the curvature of the cornea. Refractive eye surgeries are used to treat common vision disorders such as myopia, hyperopia, presbyopia and astigmatism.

<span class="mw-page-title-main">Intraocular lens</span> Lens implanted in the eye to treat cataracts or myopia

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<span class="mw-page-title-main">Corneal cross-linking</span> Surgical procedure

Corneal cross-linking (CXL) with riboflavin (vitamin B2) and UV-A light is a surgical treatment for corneal ectasia such as keratoconus, PMD, and post-LASIK ectasia.

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ICRS may refer to:

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<span class="mw-page-title-main">Astigmatism</span> Type of eye defect

Astigmatism is a type of refractive error due to rotational asymmetry in the eye's refractive power. This results in distorted or blurred vision at any distance. Other symptoms can include eyestrain, headaches, and trouble driving at night. Astigmatism often occurs at birth and can change or develop later in life. If it occurs in early life and is left untreated, it may result in amblyopia.

<span class="mw-page-title-main">Pellucid marginal degeneration</span> Degenerative corneal condition

Pellucid marginal degeneration (PMD) is a degenerative corneal condition, often confused with keratoconus. It typically presents with painless vision loss affecting both eyes. Rarely, it may cause acute vision loss with severe pain due to perforation of the cornea. It is typically characterized by a clear, bilateral thinning (ectasia) in the inferior and peripheral region of the cornea, although some cases affect only one eye. The cause of the disease remains unclear.

<span class="mw-page-title-main">Keratoprosthesis</span> Surgical procedure where a diseased cornea is replaced with an artificial one

Keratoprosthesis is a surgical procedure where a diseased cornea is replaced with an artificial cornea. Traditionally, keratoprosthesis is recommended after a person has had a failure of one or more donor corneal transplants. More recently, a less invasive, non-penetrating artificial cornea has been developed which can be used in more routine cases of corneal blindness. While conventional cornea transplant uses donor tissue for transplant, an artificial cornea is used in the keratoprosthesis procedure. The surgery is performed to restore vision in patients with severely damaged cornea due to congenital birth defects, infections, injuries and burns.

<span class="mw-page-title-main">Gholam A. Peyman</span> Iranian-American ophthalmologist and retina surgeon known for inventing LASIK eye surgery

Gholam A. Peyman is an Iranian American ophthalmologist, retina surgeon, and inventor. He is best known for his invention of LASIK eye surgery, a vision correction procedure designed to allow people to see clearly without glasses. He was awarded the first US patent for the procedure in 1989.

Peter S. Hersh is an American ophthalmologist and specialist in LASIK eye surgery, keratoconus, and diseases of the cornea. He co-authored the article in the journal Ophthalmology that presented the results of the study that led to the first approval by the U.S. Food and Drug Administration (FDA) of the excimer laser for the correction of nearsightedness in the United States. Hersh was also medical monitor of the study that led to approval of corneal collagen crosslinking for the treatment of keratoconus.

Post-LASIK ectasia is a condition similar to keratoconus where the cornea starts to bulge forwards at a variable time after LASIK, PRK, or SMILE corneal laser eye surgery. However, the physiological processes of post-LASIK ectasia seem to be different from keratoconus. The visible changes in the basal epithelial cell and anterior and posterior keratocytes linked with keratoconus were not observed in post-LASIK ectasia.

Corneal ectatic disorders or corneal ectasia are a group of uncommon, noninflammatory, eye disorders characterised by bilateral thinning of the central, paracentral, or peripheral cornea.

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An artificial iris is an intraocular implant that is used as both a cosmetic and to treat those with aniridia or other eye trauma. People with this condition experience photophobia, or increased sensitivity to light. The artificial iris, made from silicone, acts as a replacement iris. The artificial iris is implanted in the eye using different surgery techniques depending on the patient's eye trauma. Most of the major artificial iris manufacturers are European and the treatment is used sparingly in the United States because of limited FDA approval, in part due to possibility of vision loss and other risks.

References

  1. 1 2 3 4 Rabinowitz YS (2013). "INTACS for keratoconus and ectasia after LASIK". Int Ophthalmol Clin. 53 (1): 27–39. doi:10.1097/IIO.0b013e3182774453. PMC   3653443 . PMID   23221883.
  2. https://mediphacos.com/keraring.{{cite web}}: Missing or empty |title= (help)
  3. 1 2 Zadnik K, Lindsley K (2014). "Intrastromal corneal ring segments for treating keratoconus (Protocol)". Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD011150.
  4. "ICRS: Corneal Biomechanics Effects - EyeWiki". eyewiki.aao.org.
  5. 1 2 Food and Drug Administration (26 July 2004). "INTACS Prescription Inserts for Keratoconus - H040002".
  6. Food and Drug Administration (9 June 2006). "Humanitarian Device Exemption (HDE)".