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First Author: N.Al Yousuf BAHRAIN
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To study the effect of intrastromal corneal ring INTACS on keratoconus corneas
Prospective follow up study conducted on patients who underwent INTACS surgery and were followed up in an Ophthalmic Out patients Department
Thirty two eyes of 28 patients ( 21 males and 7 females) ages 19 to 44 years were studied. All patints were intolerant to contact lenses and had no corneal scarring. None of the patients studied had any coexisting eye disease or history of previous ocular surgery. None of them had connective tissue disorder or any relevant systemic or autoimmune disease. INTACS segments either a pair or a single segment were implanted in the corneal stroma. All patients underwent pre operative uncorrected visual acuity ( UCVA), best corrected visual acuity ( BCVA), manifest refraction, keratometry, pachymetry and corneal topography. The same was repeated post operatively. The follow up range was from 3 months to 11 months.
The mean age of the patients was 32 years. The mean follow up was 7 months. 81% showed improvement of 1 line or more in UCVA. ( P< 0.001). There is improvement in the mean BCVA was from 0.3 to 0.6 ( p< 0.01) . Moreover, the average cylinder has dropped from 4.2 D to 2.5 D ( P<0.002). Furthermore, there was generalized flattening in the keratometry from 63 D to 48 D.( P<0.01). 3 patients maintained their preoperative BCVA. None of the patients had deterioration. 2 patients had rings displacement for which they required repositioning of the INTACS. One patient had extrusion of one of the ring pairs which was removed.
Corneal ring implants improved UCVA and BCVA in majority of patients. It reduced the cylinder and caused generalized flattening in the corneal surface. It is highly recommended for patients with clear cornea who are contact lens intolerant as an intermediate step before embarking on keratoplasty.