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Jasmin R. Desai, Peter S. Hersh; Natural history of Intacs in keratoconus and corneal ectasia. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6801.
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The purpose of this study is to follow the topographical changes of the cornea after Intacs placement. It is also to study the improvements in UCVA and BCVA with the ring segment placements to see the effectiveness of the treatment over the 3 month time course. This treatment allows for delay of corneal trasplant and better tolerance of hard contacts lenses.
Subjects were part of a single center retrospective review of patients who received Intacs implantation for treatment of keratoconus or corneal ectasia. There were 31 eyes total of 30 patients. Patients ranged from 16 to 68 years of age, with a mean age of 43 years. Subjects were further divided into subgroups according to the Intacs segment sizes they received. Group 1 included those subjects that had asymmetrically sized segments. Group 2 included 16 patients which had two 350 µ segments in their eye. Group 3 was 3 patients, all of whom had two 450 µ segments in their eye. Group 4 consisted of 4 patients who had a single Intacs segment in the eye (sizes: 300, 350, 350, and 450 µ). Outcome measures included UCVA, BCVA, MRSE, manifest cylinder, and topographic changes(Kmax, Kavg) using the Pentacam were assessed pre- and 1 and 3 months postoperatively.
Thirty-one eyes with Intacs implantation were followed over three months. The mean UCVA preoperatively was 20/230 and was 20/142 postoperatively (p<0.01). Mean BCVA improved from 20/54 preoperatively to 20/48 at 3 months postoperatively. MRSE improved by 0.8D and corneal astigmatism improved by 1.17D (p<0.01). Topographically, Kavg flattened by 1.21D (p<0.01) and Kmax flattened by 2.52D. The UCVA improved significantly only in the group with symmetric 350 µ rings. The corneal astigmatism improved significantly for the asymmetric ring group. All other values across the 4 groups were insignificant.
Intacs improves the UCVA and BCVA for those eyes with keratoconus or corneal ectasia. Topographically, the average K flattened significantly removing some of the conical shape of the cornea. The corneal astigmatism improved over all eyes. Studying eyes by size of segment received showed that those with 350 micron segments had the most significant improvement in UCVA. Intacs is a beneficial treatment for keratoconus and corneal ectasia in the first 3 months after implantation.
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