Single Intacs segment for post-laser in situ keratomileusis keratectasia

Purpose: To describe the visual outcome of implantation of a single Intacs(R) segment (Addition Technology Inc.) in eyes with keratectasia after myopic laser in situ keratomileusis (LASIK). Setting. Private refractive surgery center, Jerusalem, Israel. Methods: This retrospective, noncomparative, interventional, consecutive, small case series studied 5 eyes of 5 patients with post-LASIK keratectasia from 3 refractive laser centers treated by Intacs implantation. Before and 9 months after Intacs implantation, the uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, keratometry, video keratography, inferior-superior asymmetry, and patient questionnaires about visual function were assessed. Results: Intacs implantation was performed 17 to 32 months post LASIK with no intraoperative complications and no loss of visual acuity. After implantation, the UCVA improved 8, 4, 3, 0.5, and 5 lines and the BSCVA, 2, 2.5, 1, 0.5, and 2 lines. The mean manifest refraction spherical equivalent improved from - 1.60 diopters (D) +/- 1.67 (SD) to - 0.80 +/- 1.05 D. The mean manifest astigmatic correction decreased from - 3.9 +/- 2.96 to - 2.46 +/- 2.77 D. Corneal topography showed improved inferior steepening and less irregular astigmatism. The mean inferior-superior asymmetry improved from 7.88 +/- 4.59 to 2.46 +/- 2.77 D. Self-reported visual symptoms improved significantly in Cases 1, 2, and 5 and slightly in Cases 3 and 4. Conclusions: Implantation of a single Intacs segment inferiorly appeared to improve progressive myopia and regular and irregular astigmatism in eyes with corneal ectasia after LASIK With further study, this technique may prove to be an effective, relatively noninvasive approach. (C) 2004 ASCRS and ESCRS.