[Intacsintracorneal ring segments in keratoconus].

Abstract

INTRODUCTION:

The spectrum of stage-related therapy of keratoconus has been broadened through surgical implantation of intracorneal ring segments (INTACS) as a possible method of reducing irregular astigmatism, leading to a reduction of corneal grafts especially in young, working-aged patients with keratoconus. The purpose of the present study was to evaluate the preoperative and postoperative results of femtosecond laser-assisted implantation of INTACS in ectatic corneal diseases.

PATIENTS AND METHODS:

From August 2011 to January 2013, 20 eyes from 16 patients with a clear cornea in the visual axis suffering from hard contact lens intolerance underwent surgery in the Homburg/Saar Keratoconus Center (HKC) by the same surgeon (MEH). Among these were 16 keratoconus eyes, 1 eye with pellucid marginal degeneration und 3 eyes with post-LASIK iatrogenic keratectasia. The insertion of the INTACS ring segments was achieved by a femtosecond laser-assisted procedure that created a precise 360° tunnel at a depth of 80% of the corneal thickness (395.8 ± 38.5 μm) in the 6–7 mm zone.Results. At 6 months follow-up mean uncorrected distance visual acuity improved from 0.07 ± 0.07 preoperatively to 0.6 ± 0.26 postoperatively. Mean best-corrected distance visual acuity changed from 0.4 ± 0.15 preoperatively to 0.9 ± 0.29 postoperatively. Mean sphere decreased from −7.6 ± 6.1 dpt to −1.4 ± 2.8 dpt. Astigmatism decreased from −6.0 ± 2.8 dpt preoperatively to −4.3 ± 2.0 dpt postoperatively. There was also a reduction in the mean flat K from 47.8 ± 4.7 dpt preoperatively to 44.2 ± 5.0 dpt postoperatively and in mean steep K from 51.9 ± 5.0 dpt to 48.4 ± 6.6 dpt. The central eccentricity index in the Pentacam was reduced to around 50%. Neither intraoperative nor postoperative complications (including non-responders) were observed.

CONCLUSIONS:

The femtosecond laser-assisted INTACS implantation provides a valid alternative to early keratoplasty for keratoconus patients with a clear central cornea and contact lens intolerance. It is a minimally invasive and reliable method for stage-related surgical management of keratoconus.

• Authors: M El-Husseiny, T Tsintarakis, T Eppig, A Langenbucher, B Seitz
• Journal: Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft (Ophthalmologe) Vol. 110 Issue 9 Pg. 823-6, 828-9 (Sep 2013) ISSN: 1433-0423 [Electronic] Germany
• Vernacular Title: Intrakorneale Ringsegmente beim Keratokonus.
• PMID: 24137764 (Publication Type: Clinical Trial, English Abstract, Journal Article)

Topics

• Adult
• Equipment Failure Analysis
• Female
• Humans
• Keratoconus (complications, diagnosis, surgery)
• Laser Therapy (methods)
• Male
• Prostheses and Implants
• Prosthesis Design
• Prosthesis Implantation (methods)
• Refractive Errors (diagnosis, etiology, prevention & control)
• Treatment Outcome
• Visual Acuity