title: Effect of inferior-segment Intacs with and without C3-R on keratoconus.
abstract: OBJECTIVE
  To determine whether corneal collagen cross-linking with riboflavin (C3-R) augments the effect of inferior-segment Intacs (Addition Technology) in the treatment of keratoconus.
  
  
  METHODS
  Private practice, Beverly Hills, California, USA.
  
  
  METHODS
  A retrospective nonrandomized comparative case series comprised 12 eyes of 9 patients who had inferior-segment Intacs placement without C3-R (Intacs-only group) and 13 eyes of 12 patients who had inferior-segment Intacs placement combined with C3-R (Intacs with C3-R group). The 2 groups were matched preoperatively. All patients had inferior-segment Intacs placed with the incision in the steep axis of manifest refraction. Corneal collagen cross-linking with riboflavin was performed after the Intacs segments were inserted. Outcome measures were topographic keratometry values and the lower-upper (L-U) ratio, which is a topographic measure of the degree of keratoconus. Preoperative data were compared to results 1 day postoperatively and measurements at the last postoperative visit.
  
  
  RESULTS
  The Intacs with C3-R group had a significantly greater reduction in cylinder than the Intacs-only group (P<.05). Steep and average keratometry were reduced significantly more in the Intacs with C3-R group (P<.05). There was a greater reduction in L-U ratio in the Intacs with C3-R group (P<.05).
  
  
  CONCLUSIONS
  The addition of C3-R to the Intacs procedure resulted in greater keratoconus improvements than Intacs insertion alone.
authors.affiliation: bbw@boxerwachler.com
authors.forename: Colin C K
authors.initials: CC
authors.lastname: Chan
authors.forename: Munish
authors.initials: M
authors.lastname: Sharma
authors.forename: Brian S Boxer
authors.initials: BS
authors.lastname: Wachler
mesh_terms: D000328:Adult; D003094:Collagen / Q000378:metabolism*; D003131:Combined Modality Therapy; D003319:Corneal Stroma / Q000187:drug effects* / Q000528:radiation effects / Q000601:surgery*; D019781:Corneal Topography; D003432:Cross-Linking Reagents / Q000528:radiation effects*; D005260:Female; D005486:Flavin Mononucleotide / Q000627:therapeutic use; D006801:Humans; D007640:Keratoconus / Q000378:metabolism / Q000628:therapy*; D008297:Male; D019904:Polymethyl Methacrylate; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014466:Ultraviolet Rays; D014792:Visual Acuity
chemical_list: D003432:Cross-Linking Reagents; D005486:Flavin Mononucleotide; D003094:Collagen; D019904:Polymethyl Methacrylate