Late Onset of Deep Corneal Vascularization: A Rare Complication of Intrastromal Corneal Ring Segments for Keratoconus

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PURPOSE: To report deep corneal vascularization noted 3 years after intrastromal corneal ringsegments (Intacs) implantation for the treatment of keratoconus. METHODS: A 33-year-old male keratoconus patient intolerant to rigid gas permeable contact lens in the right eye underwent Intacs implantation. At 2 years postoperatively, slit-lamp examination of the right eye revealed superficial corneal vascularization inferotemporally, extending 1.5 mm from the limbus. At 3 years postoperatively, the slit-lamp examination of the right eye revealed deep stromal vascularization extending to and arborizing along the temporal segment. Also, superficial vascularization was noted along the nasal segment inferiorly. The Intacs segments were then explanted. RESULTS: On post-explantation day 10, the deep vessels regressed to ghost vessels with topica corticosteroid therapy. CONCLUSIONS: The authors present a rare case where deep corneal vascularization was noticed 3 years following Intacs implantation for keratoconus. All patients having superficial vascularization away from the incision site need to be followed for this rare complication.