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E.F. Jarade, S.I. Mian, A. Scally, D.T. Azar; Combined ICRS and LASIK (IC-LASIK) for Moderate to High Myopia . Invest. Ophthalmol. Vis. Sci. 2003;44(13):967.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To describe the early results of combining Intrastromal corneal ring segment (ICRS) and Laser in situ keratomileusis (LASIK) surgery (IC-LASIK) for the treatment of moderate to high myopic patients with relatively thin corneal pachymetry. Methods: IC-LASIK is performed as a 2-stage procedure: ICRS channelling followed by LASIK and ICRS insertion 4-14 days later. 15 eyes of 11 patients with mean preoperative spherical equivalent of –9.54 ± 2.00 D (-7.13 to –13.5 D) and mean preoperative astigmatism of 1.11 ± 0.78 D (0.00 to –3.00 D) were treated with IC-LASIK. The laser nomogram was adjusted to reflect undercorrection of 3-4 D to be corrected with the ICRS. The mean central pachymetry was 524.14 ± 36.17 µm (472 to 579 µm). The ICRS size used was 0.25 mm in 10 eyes, 0.3 mm in 4 eyes and 0.35 mm in 1 eye. Results: Uncorrected visual acuity was 20/40 or better in 7/15 (46.67%) eyes at 1 month, 4/7 (57.14%) at 3 months, 2/5 (40%) at 6 months and 1/1 (100%) at 12 months. Best spectacle-corrected visual acuity (BSCVA) was 20/40 or better at all time intervals. There was no change in BSCVA in 7/15 (46.67%) eyes, two eyes gained 1 line of BSCVA, 4 eyes lost 1 line of BSCVA and 2 eyes lost 2 lines of BSCVA. No eyes lost greater than 2 lines of BSCVA. The postoperative spherical equivalent was within ± 1 D of the intended refraction in 11/15 (73.33%) eyes at 1 month, 5/7 (71.43%) eyes at 3 months, 3/5 (60%) at 6 months and 1/1 (100%) eye at 12 months and the postoperative cylinder was within ± 1 D at all time intervals. No serious complications were encountered. Conclusions: IC-LASIK is a relatively safe and effective procedure in reducing the amount of laser ablation necessary for full treatment by 1 to 3 D. It shows promising results as a tissue-saving procedure in moderate and high myopes with relatively thin corneas and may help decrease the risk of LASIK induced keractasia in these patients.
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