Simultaneous and sequential implantation of intacs and verisyse phakic intraocular lens for refractive improvement in keratectasia.
OBJECTIVE
To evaluate the safety, efficacy, and visual outcomes of simultaneous and sequential implantation of Intacs (Addition Technology, Inc, Sunnyvale, CA) and Verisyse phakic intraocular lens (AMO, Santa Ana, CA) in selected cases of ectatic corneal disease.


METHODS
John A. Moran Eye Center, University of Utah, UT.


METHODS
Prospective data were collected from 19 eyes of 12 patients (5 eyes, post-laser in situ keratomileusis ectasia and 14 eyes, keratoconus). Intacs segments were implanted followed by insertion of a phakic Verisyse lens at the same session (12 eyes) in the simultaneous group or several months later (7 eyes) in the sequential group. The uncorrected visual acuity, best spectacle-corrected visual acuity (BSCVA), and manifest refraction were recorded at each visit.


RESULTS
No intraoperative or postoperative complications were observed. At the last follow-up (19 ± 6 months), in the simultaneous group, mean spherical error was -0.79 ± 1.0 diopter (D) (range, -2.0 to +1.50 D) and cylindrical error +2.06 ± 1.21 D (range, +0.5 to +3.75 D). In the sequential group, at the last follow-up, at 36 ± 21 months, the mean spherical error was -1.64 ± 1.31 D (range, -3.25 to +1.0 D) and cylindrical error +2.07 ± 1.03 D (range, +0.75 to +3.25 D). There were no significant differences in mean uncorrected visual acuity or BSCVA between the 2 groups preoperatively or postoperatively. No eye lost lines of preoperative BSCVA.


CONCLUSIONS
Combined insertion of Intacs and Verisyse was safe and effective in all cases. The outcomes of the simultaneous implantation of the Intacs and Verisyse lens in 1 surgery were similar to the results achieved with sequential implantation using 2 surgeries.
Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA. majid.moshirfar@hsc.utah.edu
Majid
M
Moshirfar
Carlton R
CR
Fenzl
Jay J
JJ
Meyer
Marcus C
MC
Neuffer
Ladan
L
Espandar
Mark D
MD
Mifflin
D000328:Adult; D003316:Corneal Diseases / Q000209:etiology* / Q000601:surgery*; D005139:Eyeglasses; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000150:complications*; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008297:Male; D008875:Middle Aged; D054120:Phakic Intraocular Lenses; D011446:Prospective Studies; D054140:Refractive Surgical Procedures; D016896:Treatment Outcome; D014792:Visual Acuity