Biomicroscopic Findings And Management Of Anterior Stromal Necrosis After Long-Term Implantacion Of Intacs

Abstract Purpose: To evaluate the visual, refractive and biomicroscopic findings pre- and post-treatment of the observed anterior stromal necrosis (ASN) after long-term INTACS intracorneal rings segment (ICRS) implantation. Design: Consecutive interventional case series. Subjects: All consecutive patients implanted with INTACS ICRS at a single center by one of the authors from October 2006 to October 2011 with a minimum follow-up time of 5 years were included. Methods: All INTACS were implanted using the Prolate system console and instrumentation from Addition Technology (Chicago, IL). The slit lamp, refractive and visual findings and the management of those patients are described in detail. Main outcome measures: The size of the epithelial defect overlying the INTACS body and the intended implantation depth was measured by high magnification slit lamp photography and the management of the cases described in detail. The percentage of eyes with ASN out of those that reached the 5-year follow-up is reported. Results: A total of 127 eyes (84 patients) were implanted with 215 ICRS during the study period, 77,16% (98/127) eyes had a follow up of five years or longer, out of which 9 eyes (7 patients) had ASN corresponding to at least 9,18% (IC 95%: 4,29% - 16,72%), mean time between implantation and ASN diagnosis was (10.5±1.3 years). Conclusion: After 5 years of implantation, INTACS-treated eyes could present with an ASN over the ICRS body. Longer term follow-up of patients implanted with INTACS is important to monitor if this complication keeps occurring over time.