Intacs for the Treatment of Keratoconus

1
Intacs for the Treatment of Keratoconus
Ying Qian, MD Bennie H. Jeng, MD Cole Eye
Institute Cleveland Clinic Foundation Cleveland,
Ohio
Financial disclosure none
2
Introduction

• Intacs (Addition Technology, Inc, Sunnyvale, CA)
  are FDA-approved intrastromal corneal ring
  segments indicated for the treatment for mild to
  moderate keratoconus with clear central corneas
• Indicated in patients with contact lens
  intolerance
• May delay the need for penetrating keratoplasty
• Flattens the center of the cornea
• Reversible

3
Purpose

• To evaluate the efficacy of the placement of
  Intacs using the manual dissection technique in
  eyes with keratoconus

4
Method

• Retrospective review
• Eleven eyes of 11 patients with keratoconus
• Intacs placement with manual dissection technique
• One surgeon (BHJ)

5
Results
Patient Pre-op BSCVa Post-op BSCVa Pre-op Sph Equiv Pre-op K Cyl Post-op Sph Equiv Post-op K Cyl
1 20/60 20/30 -6.25 2.75 -6.25 0.75
2 20/70 20/50 -1.75 6.50 -1.50 3.12
3 20/40 20/25 -4.50 4.88 -7.13 2.63
4 20/40 20/30 -0.50 2.88 0.75 1.00
5 20/100 20/20 -2.25 4.00 1.13 3.75
6 20/80 20/60 -3.75 1.50 -4.00 1.25
7 20/200 20/60 -0.75 16.88 1.25 15.75
8 20/70 20/80 -11.87 8.00 -8.13 3.12
9 20/400 20/30 -5.00 6.38 -0.38 6.00
10 20/30 20/20 -1.50 2.87 1.50 2.37
11 20/25 20/25 -1.63 1.62 -1.38 2.12
6
(No Transcript)
7
Mean Values
Pre-Op Post-Op P value
Snellen Va (Best spectacle corrected) 20/70 20/35 0.016
LogMAR Va 0.55 0.25 0.016
Spherical Equivalent -3.61 -2.19 0.053
Keratometric Cylinder 5.30 3.59 0.011
8
Intacs Post-Op Day 1 of Patient 1
9
Corneal Topography of Patient 10
Pre-op
Post-op
10
Conclusions

• Placement of Intacs using manual dissection
  technique appears to be efficacious treatment
  modality for keratoconus
• Most patients achieve better spectacle corrected
  visual acuity with concurrent decrease in
  astigmatism