Cakir et al Dovepress Figure 3 Patient’s postoperative Orbscan II® corneal topography imaging information. and iatrogenic postrefractive surgery corneal ectasias.5,6 However, there have been no reports on their use in alkali burn corneas. The patient discussed here had been scheduled for PK in another clinic when he was first seen by the authors for a second opinion. Having high-risk characteristics for corneal graft rejection, the authors recommended a trial for intracorneal ring surgery, which would not rule out future PK in the case of an unsuccessful outcome. To achieve the maximum improvement in astigmatism in the central optic zone of the cornea, ICRS with smaller inner diameter were selected for implantation (ie, KeraRing®, Mediphacos). The thickness of the rings and depth of intracorneal chan- nels were selected using the nomogram provided by the manufacturer. Given the high amount of astigmatism, implantation of two rings along the horizontal axis was planned. The second-line strategy would be placing one ring superiorly; however, the amount of cylinder that is expected to be corrected with that technique is low. The femtosecond laser was used to create the intracorneal channels in this case, since it was of paramount importance that they be created at uniform intracorneal depth. During 1634 submit your manuscript | www.dovepress.com Dovepress manual intracorneal channel formation in such an injured cornea, epithelial disturbance and associated stromal edema can be inevitable and posterior corneal perforation the worst complication.6 In this case, it was aimed to arrest the laser shoots in the thinnest areas of the cornea, where the anterior chamber structures could have been affected. For this purpose, the region of the cone that corresponded to the inferior thinned segment of the cornea was covered by gelatinous paper. The gelatinous paper is covered with aluminium foil, which is used in the industry due to its resistance and protection performance for femtosecond laser illumination,10 the beam of which can travel in the transparent media and cause destruction to the tissue at a focused plane of predetermined distance, unlike the 196 nm excimer laser beam, which ablates the tissue it faces within a range of distances. A C-shaped intracorneal channel, rather than a full circle, allowed the implantation of the intracorneal rings. Creating individual channels separately would have been harder to accomplish due to the technical difficulties in placing them at a regular distance from each other around the pupil, at dif- ferent applications of the femtosecond laser cone. Therefore, Clinical Ophthalmology 2011:5