title: INTACS before or after laser in situ keratomileusis: correction of thin corneas with moderately high myopia.
abstract: OBJECTIVE
  Intrastromal corneal ring segments (INTACS Micro-Thin Prescription Inserts by Addition Technologies, Fremont, Calif) were inserted as a combined surgery with laser in situ keratomileusis (LASIK) in six eyes with thin corneas to correct moderately high myopia.
  
  
  METHODS
  INTACS were implanted before LASIK (INTACS-LASIK) in three eyes and after LASIK (LASIK-INTACS) in three eyes. Mean preoperative manifest spherical equivalent refraction was -7.88 diopters. Mean follow-up was 306 days.
  
  
  RESULTS
  No intraoperative complications occurred. The LASIK-INTACS eyes were slightly more overcorrected than the INTACS-LASIK eyes because of the enhanced performance of INTACS in the thinned corneal tissue. Induced astigmatism by INTACS per se was less in the LASIK-INTACS eyes than in the INTACS-LASIK eyes. At last examination, uncorrected visual acuity was better than 20/25 in all eyes. Best spectacle-corrected visual acuity was within 1 line of the preoperative value in all eyes.
  
  
  CONCLUSIONS
  Both methods resulted in significant improvement in visual acuity and refraction. Based on our limited experience, however, LASIK followed by INTACS is preferred for reasons of safety, convenience, and lower induced cylinder.
authors.affiliation: Minamiaoyama Eye Clinic, Minamiaoyama 2-27-25, Minato-ku, Tokyo 107-0062, Japan. mito@minamiaoyama.or.jp
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Ito
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Arai
authors.forename: Teruki
authors.initials: T
authors.lastname: Fukumoto
authors.forename: Ikuko
authors.initials: I
authors.lastname: Toda
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tsubota
mesh_terms: D000328:Adult; D003319:Corneal Stroma / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D011182:Postoperative Care; D011300:Preoperative Care; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000379:methods*; D012029:Refraction, Ocular / Q000502:physiology; D012086:Reoperation; D012449:Safety; D014792:Visual Acuity / Q000502:physiology