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disclosure no financial interest Intrastromal Corneal Ring Segment Implantation for Advanced Keratoconus Paulo Torres, Rita Reis, Isabel Sampaio, Mª Antonia Costa, Nuno Alves, Miguel Gomes, Luis Oliveira Cornea and External Disease Unit - Hospital St. António - Porto - PORTUGAL

Disclosure no financial interest Intrastromal Corneal Ring Segment Implantation for Advanced Keratoconus Paulo Torres, Rita Reis, Isabel Sampaio, Mª Antonia

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Page 1: Disclosure no financial interest Intrastromal Corneal Ring Segment Implantation for Advanced Keratoconus Paulo Torres, Rita Reis, Isabel Sampaio, Mª Antonia

disclosure

no financial interest

Intrastromal Corneal Ring Segment Implantation for Advanced

Keratoconus

Paulo Torres, Rita Reis, Isabel Sampaio, Mª Antonia Costa,

Nuno Alves, Miguel Gomes, Luis Oliveira

Cornea and External Disease Unit - Hospital St. António - Porto - PORTUGAL

disclosure: no financial interest

Page 2: Disclosure no financial interest Intrastromal Corneal Ring Segment Implantation for Advanced Keratoconus Paulo Torres, Rita Reis, Isabel Sampaio, Mª Antonia

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PURPOSE

evaluate the refractive and visual results of Intacs SK (6 mm diameter)

for patients with advanced keratoconus (k > 55D)

Page 3: Disclosure no financial interest Intrastromal Corneal Ring Segment Implantation for Advanced Keratoconus Paulo Torres, Rita Reis, Isabel Sampaio, Mª Antonia

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MATERIAL/METHODS

• 20 eyes (20 patients)• severe keratoconus (> 55D)

• UCVA, BSCVA, SE, Ks

• topical anesthesia• incision: 80% deep, steepest axis

• 8 months minimum follow-up

Page 4: Disclosure no financial interest Intrastromal Corneal Ring Segment Implantation for Advanced Keratoconus Paulo Torres, Rita Reis, Isabel Sampaio, Mª Antonia

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K-readings

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pre-op pos-op

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57,5 52,9

Page 5: Disclosure no financial interest Intrastromal Corneal Ring Segment Implantation for Advanced Keratoconus Paulo Torres, Rita Reis, Isabel Sampaio, Mª Antonia

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Spherical Equivalent

pre-op pos-op0

2

4

6

8

10

12

14

16

Category 1 Category 2 Category 3

10,35

4,66

16

Series 1

Series 2

Series 3

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-4,66

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-10,35

pre-op pos-op

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-16

-14

-12

-10

-8

-6

-4

-2

0

Page 6: Disclosure no financial interest Intrastromal Corneal Ring Segment Implantation for Advanced Keratoconus Paulo Torres, Rita Reis, Isabel Sampaio, Mª Antonia

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UCVA

pre-op pos-op

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20/400

20/80Novidades no

olho seco

20/20

20/200

Page 7: Disclosure no financial interest Intrastromal Corneal Ring Segment Implantation for Advanced Keratoconus Paulo Torres, Rita Reis, Isabel Sampaio, Mª Antonia

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BSCVA

pre-op pos-op

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20/45

20/200

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20/20

20/200

Page 8: Disclosure no financial interest Intrastromal Corneal Ring Segment Implantation for Advanced Keratoconus Paulo Torres, Rita Reis, Isabel Sampaio, Mª Antonia

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BSCVA (pre-op/pos-op)

0

0,1

0,2

0,3

0,4

0,5

0,6

0,7

0,8

0,9

1

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Série 1

Série 2

Série 3

Série 4

Série 5

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20/20

20/25

20/40

20/200

Page 9: Disclosure no financial interest Intrastromal Corneal Ring Segment Implantation for Advanced Keratoconus Paulo Torres, Rita Reis, Isabel Sampaio, Mª Antonia

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CASE EXAMPLE 1

pre-op

BSCVA: 20/80 +0,50-3,00(60)

Ks: 50,9/58,0

pos-op

UCVA: 20/25

Ks: 46,3/53,4

Page 10: Disclosure no financial interest Intrastromal Corneal Ring Segment Implantation for Advanced Keratoconus Paulo Torres, Rita Reis, Isabel Sampaio, Mª Antonia

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CASE EXAMPLE 2

pre-op

BSCVA: 20/400 -3,50-4,00(20)

Ks: 49,7/58,7

pos-op

UCVA: 20/40 BSCVA: 20/25 -0,25-3,00(30)

Ks: 46,0/51,6

Page 11: Disclosure no financial interest Intrastromal Corneal Ring Segment Implantation for Advanced Keratoconus Paulo Torres, Rita Reis, Isabel Sampaio, Mª Antonia

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BSCVA (pre-op/pos-op)

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20/20

20/25

20/40

20/200

K>55D

Intacs SK(n = 20)

K<55D

7 mm Intacs(n = 223)

K>55D

7 mm Intacs(n = 18)

advanced keratoconus (K>55D)

7 mm Intacs vs Intacs SK

Page 12: Disclosure no financial interest Intrastromal Corneal Ring Segment Implantation for Advanced Keratoconus Paulo Torres, Rita Reis, Isabel Sampaio, Mª Antonia

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CONCLUSIONS

• safe and effective• delay/avoid keratoplasty• no lost BSCVA• better then 7 mm Intacs for advanced keratoconus

• long term stability ?

• max. Ks (60-62D)