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Objectives: To describe the visual outcome of keratoconus managed with Intacs implantation (Addition Technology Inc, Fremont, Calif) and to define criteria that predict good outcome. Methods: This retrospective, nonrandomized, comparative, consecutive case series studied 58 eyes of 43 patients with keratoconus managed by Intacs implantation. The outcome measures were analyzed pre-Intacs and 1 year post-Intacs. Preoperative parameters were correlated with outcome. Main Outcome Measures: Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, videokeratography, and patient questionnaires. Results: Intacs were implanted in all eyes with no intraoperative complications. Six eyes underwent additional Intacs surgery. Post-Intacs, the mean± SD UCVA improved from less than 20/200± 0.1 line to 20/ 50- 3± 3.1 lines, the mean± SD BSCVA was unchanged at 20/32± 2.0 lines, the mean± SD spherical equivalent improved from- 3.88± 1.64 to - 1.04± 1.51 diopters (D), and the mean± SD astigmatism improved from 3.34± 2.23 to 1.97± 1.51 D. Twenty-five eyes had a good outcome (UCVA≥ 20/40). Multiple regression selected BSCVA, astigmatism, and spherical myopia as the preoperative predictors of outcome. Conclusions: Intacs improve myopia and regular astigmatism in keratoconus. Milder keratoconus (BSCVA>20/ 32- 2 and astigmatism< 3.50 D) and significant spherical myopia (>- 1.75) predict better outcome.
Objectives: To describe the visual outcome of keratoconus managed with Intacs implantation (Addition Technology Inc, Fremont, Calif) and to define criteria that predict good outcome. Methods: This retrospective, nonrandomized, comparative, consecutive case series studied 58 eyes of 43 patients with The outcome measures were analyzed pre-Intacs and 1 year post-Intacs. Preoperative parameters were correlated with outcome. Main Outcome Measures: Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, videokeratography, and patient questionnaires. Results: Intacs were implanted in all eyes with no intraoperative complications. Six eyes underwent additional Intacs surgery. Post-Intacs, the mean ± SD UCVA improved from less than 20/200 ± 0.1 line to 20 / 50- 3 ± 3.1 lines, the mean ± SD BSCVA was unchanged at 20/32 ± 2.0 lines, the mean ± SD spherical equivalent improved from- 3.88 ± 1.64 to -1.04 ± 1. 51 diopters (D), and the mean ± SD astigmatism improved from 3.34 ± 2.23 to 1.97 ± 1.51 D. Twenty-five eyes had a good outcome (UCVA ≥ 20/40). Multiple regression selected BSCVA, astigmatism, and spherical myopia as The preoperative predictors of outcome. Conclusions: Intacs improve myopia and regular astigmatism in keratoconus. Milder keratoconus (BSCVA> 20 / 32-2 and astigmatism <3.50 D) and significant spherical myopia (>