Official ESCRS | European Society of Cataract & Refractive Surgeons
Copenhagen 2016 Registration Programme Exhibitor Information Virtual Exhibition Satellite Meetings Glaucoma Day 2016 Hotel Star Alliance

10 - 14 Sept. 2016, Bella Center, Copenhagen, Denmark

This Meeting has been awarded 27 CME credits


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Treatment of advanced keratoconus with INTACS SK intrastromal corneal ring segment: 5 year outcomes

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Session Details

Session Title: Cornea Surgical II

Session Date/Time: Tuesday 13/09/2016 | 08:00-10:30

Paper Time: 08:06

Venue: Hall C2

First Author: : J.Court UK

Co Author(s): :    M. Muhtaseb                    

Abstract Details


To report the long-term efficacy, stability and safety of INTACS SK intrastromal corneal ring segments (ICRS) to manage advanced keratoconus, where regular INTACS are likely to have limited results, as a strategy for delaying the need for keratoplasty. 5 year follow-up data are presented.


Singleton Hospital, Abertawe Bro Morgannwg University Health Board, Swansea, United Kingdom


INTACS SK ICRS were manually implanted in 34 eyes of 30 patients with moderate to advanced keratoconus (defined as mean keratometry (K) >53.0 dioptres (D), or keratometric astigmatism >4D with a mean K of 49.0-53.0D). Outcome measures included uncorrected (UDVA) and corrected distance visual acuity (CDVA), contact lens (CL) tolerance, 'real-life' visual acuity (RDVA) (uncorrected, spectacle or CL corrected acuity as worn by the patient day to day), extrusion rates and late complications. Length of follow-up was 5 years post-implantation.


Mean UDVA, CDVA and RDVA were improved 5 years post-operatively (0.99LogMAR, 0.41LogMAR and 0.58LogMAR respectively) versus pre-operatively (1.38LogMAR, 1.03LogMAR and 1.24LogMAR) (p<0.01). 19% regularly wore CL at 5 years, with 75% identifying preference and good spectacle CDVA as the main reason for not using CL, rather than poor tolerance. No statistically significant difference was found in UDVA, CDVA or RDVA between 1 and 5 years (p= 0.47, 0.69 and 0.89), showing stability. Early extrusion (<6 months) occurred in 14.7%. 2 patients required late removal for vascularisation, and 1 for extrusion complicated by infection. Atopy was a risk factor for extrusion.


ICRS implantation achieved beneficial results in advanced keratoconus, with stability over 5 years of follow-up. Regularisation of the cornea improved both spectacle CDVA and CL tolerance. A slightly higher extrusion rate was seen in atopic patients and in more advanced keratoconus with steeper Ks than in some previous reports.

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