Intacs in advanced keratoconus.
OBJECTIVE
To evaluate the surgical outcomes of microthin intracorneal ring segment (INTACS) implantation in advanced keratoconus.


METHODS
INTACS implantation was performed in eyes with advanced keratoconus. The main outcome measures were uncorrected visual acuity, best spectacle-corrected visual acuity, change in mean refractive spherical equivalent (MRSE), and keratometry.


RESULTS
Intacs were implanted in 14 eyes with advanced keratoconus. At 6 months, uncorrected visual acuity improved from 0.05 +/- 0.08 to 0.16 +/- 0.11 (P < 0.05), and best spectacle-corrected visual acuity improved from 0.50 +/- 0.23 to 0.67 +/- 0.00 (P = 0.01). The spherical refractive error improved from -6.68 D +/- 6.44 to -3.11 D +/- 3.08 (P = 0.03), whereas the cylindrical refractive error improved from -4.89 D +/- 1.91 to -3.64 D +/- 1.27 (P = 0.04). The MRSE reduced from -9.13 D +/- 5.62 to -4.93 D +/- 3.19 (P = 0.01), and the average keratometry decreased from 53.01 D +/- 3.70 to 49.42 D +/- 3.79 (P < 0.05). The results were stable from 6 months to 1 year. The procedure showed 100% safety, and more than 60% tolerated contact lenses. Younger age, male sex, and minimum central pachymetry of more than 400 microm seemed to be associated with better outcomes.


CONCLUSIONS
In this series, Intacs provided good results with respect to visual acuity, corneal topography, and MRSE in eyes with advanced keratoconus without major complications or the need for segment explanation. INTACS is potentially a safe and efficacious treatment option in the management of advanced keratoconus.
Shetty
Rohit
R
Cornea and Refractive Surgery Service, Narayana Nethralaya, Postgraduate Institute of Ophthalmology, Bangalore, India. drrohitshetty@yahoo.com
Kurian
Mathew
M
Anand
Doraiswamy
D
Mhaske
Prerna
P
Narayana
Kannan M
KM
Shetty
Bhujang K
BK
D000328:Adult; D003315:Cornea / Q000601:surgery*; D019781:Corneal Topography; D018450:Disease Progression; D004867:Equipment Design; D005139:Eyeglasses; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000009:adverse effects; D012030:Refractive Errors / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult