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Laser in situ keratomileusis results after intrastromal corneal ring segments (Intacs)
Objective:
To evaluate the safety and efficacy of laser in situ keratomileusis (LASIK) after removal of intrastromal corneal ring segments (Intacs, KeraVision, Fremont, CA) from the cornea.
Design:
Single-center, noncomparative, interventional, consecutive case series.
Participants:
Nine eyes of nine consecutive patients who had undergone LASIK after Intacs of experimental design removal were analyzed for this study.
Intervention:
A standard LASIK procedure was performed with the Nidek EC 5000 excimer laser (Nidek, Gamagori, Japan) at intervals between 4 and 10 months after Intacs explantation. A Nidek MK 2000 microkeratome (Nidek, Gamagori, Japan) or a Chiron Automated Corneal Shaper (Bausch & Lomb, Claremont, CA) with a 130- to 180-microm thickness plate was used to create a nasal hinged flap in a plane superficial to the previous Intacs channel.
Main Outcome Measures:
Uncorrected visual acuity, manifest refraction, best spectacle-corrected visual acuity, and topography were measured preoperatively and at months 1, 3, 6, and 12 after LASIK.
Results:
Faint residual scarring in the channels after Intacs removal was seen in all patients. No difficulties were encountered during the ablation or flap replacement. Eight of nine patients had 20/20 or better uncorrected visual acuity after a single LASIK procedure. Mean spherical equivalent at 12 months was -0.6, ranging from -1.25 to +0.25 diopter. One patient had glare develop secondary to superior corneal thinning and scarring after implantation of a nonstandard Intacs. No patient lost lines of best spectacle-corrected vision after LASIK.
Conclusion:
Reversibility of the myopic Intacs is demonstrated. Removal of Intacs may be followed by a safe and effective LASIK for low to moderate myopia.
