Intacs implantation with sequential collagen cross-linking treatment in postoperative LASIK ectasia

J Refract Surg. 2008 Sep;24(7):S726-9. doi: 10.3928/1081597X-20080901-16.

Abstract

Purpose: To report the postoperative course and refractive results of each eye of a patient with postoperative LASIK ectasia for whom Intacs SK (severe keratoconus, Addition Technology Inc) implantation and collagen crosslinking (CXL) treatments were performed.

Methods: A 27-year-old man with postoperative LASIK ectasia with best spectacle-corrected visual acuity (BSCVA) of 20/60 and 20/80 in the right and left eyes, respectively, was operated for Intacs SK implantation for both eyes. Spherical equivalent refraction and mean keratometric values in the right and left eyes were -14.50 diopters (D) and -10.50 D and 56.20 D and 50.70 D, respectively. Following bilateral Intacs SK implantation, CXL was performed after 1 day in the left eye and 1 month in the right eye.

Results: During follow up, there was an improvement in visual acuity and decrease in manifest refraction and keratometric values in both eyes. A slight regression of these values was noted in the right eye 1 month after Intacs SK implantation, which was reversed by CXL. Eight months postoperatively, BSCVA was 20/25 and 20/25, manifest refractions were -1.50 x 170 and -1.25 x 50, and mean keratometric values were 47.20 and 44.20 D in the right and left eyes, respectively.

Conclusions: Intacs SK implantation and subsequent CXL may be alternatived in the treatment of postoperative LASIK ectasia.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Collagen / metabolism*
  • Combined Modality Therapy
  • Cornea / drug effects
  • Cornea / metabolism
  • Cornea / pathology
  • Cornea / radiation effects
  • Cornea / surgery
  • Corneal Diseases / drug therapy
  • Corneal Diseases / etiology
  • Corneal Diseases / surgery
  • Corneal Diseases / therapy*
  • Corneal Stroma / drug effects
  • Corneal Stroma / metabolism
  • Corneal Stroma / radiation effects
  • Corneal Topography
  • Dilatation, Pathologic / drug therapy
  • Dilatation, Pathologic / etiology
  • Dilatation, Pathologic / surgery
  • Humans
  • Keratomileusis, Laser In Situ*
  • Male
  • Myopia / surgery
  • Photochemotherapy*
  • Photosensitizing Agents / therapeutic use
  • Polymethyl Methacrylate
  • Postoperative Complications*
  • Prostheses and Implants
  • Prosthesis Implantation*
  • Riboflavin / therapeutic use
  • Ultraviolet Rays
  • Visual Acuity

Substances

  • Photosensitizing Agents
  • Collagen
  • Polymethyl Methacrylate
  • Riboflavin