Treatment of six cases of advanced ectasia after LASIK with 6-mm Intacs SK.

PURPOSE: To describe the outcome after implantation of 6-mm Intacs SK implants (Addition Technology Inc) for treatment of ectasia after LASIK. METHODS: Retrospective descriptive longitudinal case series. Seven eyes of 6 patients with advanced keratectasia after LASIK were treated with 6-mm Intacs SK implantation. Parameters evaluated preoperatively and at 9 months were uncorrected (UCVA) and best spectacle-corrected visual acuity (BSCVA), average keratometry (AvK), and spherical equivalent refractive error (SEQ). RESULTS: Mean preoperative UCVA was 1.56 +/ - 0.43 logMAR (approximately 20/800), BSCVA was 0.57 +/ - 0.24 logMAR (approximately 20/75), SEQ was -14.67 +/- 5.30 diopters (D), and AvK was 53.80 +/ - 6.30 D. Postoperative examination showed a clinically significant improvement in UCVA, which improved to 0.27+/- 0.14 logMAR (approximately 20/40). Mean BSCVA improved to 0.24 +/- 0.08 logMAR (approximately 20/32), mean SEQ reduced to -2.93 +/- 0.86 D, and AvK reduced to 48.57 +/ - 5.00 D. CONCLUSIONS: Within the scope of six cases with 9-month postoperative follow-up, implantation of 6-mm Intacs SK appears to be a safe and effective treatment option for management of advanced cases of keratectasia after LASIK.

Penetrating keratoplasty versus intrastromal corneal ring segments to correct bilateral corneal ectasia: preliminary study.

PURPOSE: To describe the outcomes over time in patients with corneal ectasia pathology treated with intrastromal corneal ring segments (Intacs, Addition Technology, Inc.) in 1 eye and penetrating keratoplasty (PKP) in the other eye. SETTING: Clinica de Cornea, Centro Medico Docente La Trinidad, Caracas, Venezuela. METHODS: A nonrandomized comparative study and analysis of retrospective data comprised 17 patients who had PKP in 1 eye and Intacs implantation in the other eye. Patients were classified into 2 groups: asymmetric (different grade of keratoconus in each eye) and symmetric (same grade of keratoconus in both eyes). Parameters analyzed included uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and keratometry (flat and steep values and astigmatism readings). Follow-up after PKP was at 24 hours and 6 and 24 months and after Intacs implantation, at 24 hours and 3 and 10 months. RESULTS: In both groups, UCVA improved and the corneal shape was normal. No patient lost a line of acuity, and BCVA improved in both groups. CONCLUSIONS: Eyes with Intacs had a shorter recovery time than eyes having PKP. The eyes with Intacs had no complications. Complications in eyes with PKP included cataract, graft rejection, and elevated intraocular pressure. Thus, Intacs segments may delay or prevent the need for a corneal graft, although longer follow-up is needed.