Laser in situ keratomileusis results after intrastromal corneal ring segments (Intacs)

Abstract

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-μm 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.