Intacs adjustment surgery for keratoconus

Purpose To describe the visual outcome of keratoconic eyes managed with Intacs (Addition Technology, Inc.) that required additional Intacs surgery (defined as any combination of removal, exchange, addition, or shifting of an Intacs segment). Setting Private refractive surgery center, Jerusalem, Israel. Methods This retrospective noncomparative interventional consecutive small case series studied all eyes of a cohort of 58 keratoconic eyes managed with Intacs that had additional Intacs surgery. The uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity, manifest refraction, videokeratography, and patient questionnaires on visual function were assessed. These outcome measures were compared before Intacs implantation, before Intacs adjustment, and 1 year after the final Intacs adjustment. Eyes having any intervention other than Intacs surgery were excluded. Results Of 58 keratoconic eyes managed with Intacs, 7 had additional Intacs surgery. After the initial Intacs surgery, 6 of these eyes had UCVA ≤20/100 and 1 had UCVA of 20/50. After the final Intacs adjustment, 3 eyes achieved UCVA ≥20/40, 5 achieved UCVA ≥20/70, and 2 remained Conclusions Approximately 10% of keratoconic eyes managed with Intacs may require Intacs adjustment surgery, which often has a good outcome.