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Dominique PIETRINI, MD Tony GUEDJ,OD,ORTH Clinique de la Vision, Paris. dpietrini@club.fr

Dominique PIETRINI, MD Tony GUEDJ,OD,ORTH Clinique de la Vision, Paris. dpietrini@club.fr Financial disclosure: Dr D. Pietrini is a paid consultant for Mediphacos. Femtosecond laser assisted intrastromal corneal ring segment implantation for post- lasik corneal ectasia.

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Dominique PIETRINI, MD Tony GUEDJ,OD,ORTH Clinique de la Vision, Paris. dpietrini@club.fr

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  1. Dominique PIETRINI, MD Tony GUEDJ,OD,ORTH Clinique de la Vision, Paris. dpietrini@club.fr Financial disclosure: Dr D. Pietrini is a paid consultant for Mediphacos Femtosecond laser assisted intrastromal corneal ring segment implantation for post-lasik corneal ectasia

  2. Materials and Methods • 13 eyes with post lasik ectasia, follow up 6 months to 4 years. • Mean age 38 years • Initial surgery • Microkeratome 80% Femtosecond 20% • Time between lasik ands ICRS 3 years • Form frust keratoconus in 8 cases / Insufficient stromal bed 2 cases / unkown etiology or association remaining cases • ICRS femtosecond implantation all cases • 3 eyes implanted with Intacs (Addition technology) • 10 eyes implanted with Kerarings (Mediphacos) • Interest of OCT for corneal evaluation • Mean flap thickness 148µm +/- 16.5µm (120/200) • Mean residual stromal bed 294µm +/- 55.1µm (210/400)

  3. Evolution of sphericalequivalent and refractivecylinder N=13

  4. Evolution of uncorrected and best correctedvisualacuity UCVA Mean gain 5 lines BCVA Mean gain 3 lines p<0.05 N=13

  5. KeratometricmeasurementsOrbscanreadings Keratometry Mean K reduced by 3D Kmax reduced by 4.6D p<0.05 N=13

  6. Cornealastigmatism N=13

  7. High Order Aberration HOA Rms showed a reduction of 59% after 2years for Two eyes Vertical Coma showed a reduction of 69% after 2years for Two Eyes H.Coma N=2

  8. Case Report M. A.B,Man, 33 yearsold Post lasikectasia: Marginal pellucidcornealdystrophy

  9. OCT Visante Corneal Flap OCT PRE OP : Size of corneal flap Post lasik ectasia on marginal pellucid corneal dystrophy Corneal Flap KERARING OCT POST OP KERARING: Depth: 310µm Corneal Flap: 120µm

  10. Orbscan Dual POST LASIK ECTASIA : Marginal pellucid corneal dystrophy Corneal Flap OCT PRE OP POST LASIK ECTASIA PRE OP REFRACTION: +1,75 (-4,50)85° UCVA:0.5 Log mar BCVA:0.0 Log mar POST OP 1 Week REFRACTION: +2.50 (-2.50)85° UCVA :0.0 Log mar BCVA:-0.1 Log mar Corneal Flap KERARING OCT POST OP POST LASIK ECTASIA POST KERARING DEPTH: 330µm Corneal Flap: 120µm

  11. CONCLUSION • Femtosecond intrastromal corneal ring segment implantation is an affective and safe method for the management of post lasik ectasia. • Restores good level of visual acuity. • Objective improvement of visual acuity. • BCVA improved by 3 lines. • Corneal astigmatism reduced by 2,6 d. • Maximal keratometry reduced by 4.6 diopters. • Reduce Hoa Rms. • High patient satisfaction. • Low complications rate. • Reversible.

  12. Dominique Pietrini, MD, is a member of the active staff of the Clinique de la Vision, Paris France. Dr. Dominique Pietrini states that he is a paid consultant to Mediphacos. Dr. Pietrini can be reached at +33 145 630 668 dpietrini@club.fr www.cliniquevsion .com

  13. Tony Guedj, OD,ORT Clinique de la vision, Paris France. Tony Guedj can be reached at +33 145 630 668 tony.guedj@yahoo.fr

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