Advanced Cases of Ectasia and Use of ICRS Implantation
Narrative Responses:
Purpose
To report the efficacy and safety of INTACS implantation using a femtosecond laser in the management of advanced keratoconus.
Methods
A single center, retrospective, non-comparative study included 21 keratoconic eyes (stage II-III) of 16 patients who underwent femtosecond-assisted INTACS SK implantation.
Evaluation included refraction, slit lamp examination, corneal topography, uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA).Patients were divided into subgroups based grading severity on Amsler-Krumich classification.Postoperative visits were at 1, 7, 30 days, 3 and 6 months.
Results
The study evaluated 21 eyes of 16 patients with a mean age of 26 years (range 18-37 years). Of the 21 eyes, 9 eyes were of stage III.
The mean UCVA was significantly better 6 months postoperatively than preoperatively (decimal notation 0.31 vs 0.20 respectively) as was the mean BCVA ( decimal notation 0.63 VS 0.59 respectively). The mean spherical equivalent refractive error was -6 diopters (D) preoperatively and -3.90 D at 6 months; the mean refractive astigmatism, -5.3 D and -4D, respectively; and the mean simulated keratometry value, 49.6 D and 45.8 D, respectively. There were no complications, except for a single case that developed neovascularistaion.
Conclusion
Implantation of INTACS for advanced keratoconus was safe and effective, leading to improvement in UCVA, BCVA and topographic images. It is also minimally invasive, reversible and therefore has a potential benefit over corneal transplant procedures. It can also improve tolerance for hard and soft contact lenses and delay the need for corneal transplant.