Long-term follow-up of Intacs in keratoconus.
OBJECTIVE
To evaluate long-term follow-up of Intacs microthin prescription inserts (Addition Technology, Inc, Fremont, California, USA) for the management of keratoconus.


METHODS
A long-term (five years) retrospective, follow-up study.


METHODS
Seventeen eyes of 15 patients with keratoconus ages 24 to 52 years (mean age +/- standard deviation [SD], 34.0 +/- 10.5 years) who had completed five years of follow-up (mean follow-up +/- SD, 67.2 +/- 7.5 months; range, 58 to 78 months) were included. Two Intacs segments of 0.45-mm thickness were inserted in the cornea of each eye, aiming at embracing the keratoconus area to try to achieve maximal flattening.


RESULTS
No late postoperative complications occurred in this series of patients. At five years, the spherical equivalent error was statistically significantly reduced (pre-Intacs, mean +/- SD -5.54 +/- 5.02 diopters [D]; range, -12.50 to 3.63 D; -3.02 +/- 2.65 D; range, -8.25 to 1.88 D) (P = .01). Pre-Intacs uncorrected visual acuity (UCVA) was 20/50 or worse in all eyes (range, counting fingers to 20/50), whereas, at the last follow-up examination, 10 (59%) of 17 eyes had UCVA of 20/50 or better (range, counting fingers to 20/32). Six eyes (35%) maintained the pre-Intacs best spectacle-corrected visual acuity (BSCVA) and one eye lost 3 lines of BSCVA, whereas the rest of the 10 eyes (59%) experienced a gain of one up to 8 lines.


CONCLUSIONS
After five years, intracorneal ring segments implantation improved UCVA, BSCVA, and refraction in the majority of the keratoconus patients. There was no evidence of progressive sight-threatening complications in this study.
Kymionis
George D
GD
Department of Ophthalmology, Institute of Vision and Optics, University of Crete, Crete, Greece. kymionis@med.uoc.gr
Siganos
Charalambos S
CS
Tsiklis
Nikolaos S
NS
Anastasakis
Anastasios
A
Yoo
Sonia H
SH
Pallikaris
Aristofanis I
AI
Astyrakakis
Nikolaos
N
Pallikaris
Ioannis G
IG
D000328:Adult; D003315:Cornea / Q000503:physiopathology* / Q000601:surgery; D019781:Corneal Topography; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000503:physiopathology* / Q000601:surgery*; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D019904:Polymethyl Methacrylate; D011183:Postoperative Complications; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000379:methods*; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014792:Visual Acuity / Q000502:physiology*
D019904:Polymethyl Methacrylate