Outcomes of Single Segment Implantation of Conventional Intacs versus Intacs SK for Keratoconus

PURPOSE To compare the visual, refractive, and keratometric outcomes of single-segment conventional and severe keratoconus (SK) types of Intacs for correction of inferior keratoconus (KCN). METHODS A total number of 41 consecutive eyes of 23 patients with a diagnosis of inferior KCN underwent Intacs implantation. Eight eyes were excluded due to postoperative complications (4 eyes) and loss to follow-up (4 eyes) and finally 33 eyes underwent statistical analysis. Two groups were created according to Intacs type insertion; conventional group (17 eyes) and SK groups (16 eyes). Intracorneal ring segments (ICRS) implantation was indicated in keratoconic patients with contact-lens intolerance or reduced best spectacle-corrected visual acuity (BSCVA). RESULTS In the conventional group, mean uncorrected distance visual acuity (UCDVA) improved from 0.45 ± 0.41 preoperatively to 0.69 ± 0.39 six months after surgery representing a gain of 2 Snellen lines, and in the SK group mean UCDVA changed from 0.40 ± 0.35 preoperatively to 0.58 ± 0.48 equivalent to two Snellen lines improvement 6 months after operation (P = 0.48). Mean preoperative BSCVA in the conventional group improved from 0.72 ± 0.41 to 0.86 ± 0.39 (2 lines improvement) postoperatively and in the SK group improved from 0.71 ± 0.69 to 0.75 ± 0.45 (0.50 line improvement) (P = 0.29). Mean preoperative spherical equivalent (SE) decreased from -4.86 ± 2.26 D to -3.57 ± 2.21 D (conventional group) and from -4.20 ± 1.82 D to -3.60 ± 1.89 D (P = 0.34), mean astigmatism (AST) decreased from -5.20 ± 2.07 D and -4.50 ± 2.26 D to -4.02 ± 2.57 D and - 3.18 ± 2.14 D in the conventional and SK groups, respectively (P = 0.68). Finally, mean K min decreased from 47.11 ± 2.51 D to 45.40 ± 3.30 D in the conventional group and from 45.05 ± 2.59 D to 44 ± 3.88 D in the SK group (P = 0.63) and mean K max was decreased from 52.82 ± 3.23 D to 50.52 ± 3.57 D and from 49.72 ± 3.17 D to 48.55 ± 4.50 D, respectively (P = 0.48). CONCLUSION Single-segment implantation of conventional and SK Intacs improved UCDVA and BSCVA, decreased corneal AST and keratometry in both groups with comparable outcomes.