Utilization of refractive surgery technology in keratoconus and corneal transplants

Abstract

Keratoconus is considered a contraindication for refractive surgery because of the potential corneal instability following surgery. On the other hand, penetrating keratoplasty is the usual surgical modality when the keratoconic patient cannot tolerate a contact lens. In some selected cases, when the central cornea is still transparent, refractive surgical procedures, particularly Intacs implantation, may be used to help the patient to improve visual function.

Intacs for the correction of keratoconus: Two-year follow-up

“…6,7 Several studies show that implantation of Intacs is a safe, reversible procedure that improves objective visual outcomes and restores functional vision in most keratoconus patients. [8][9][10][11] This suggests that Intacs segments should be a valuable surgical alternative that may restore contact lens tolerance and delay or prevent corneal transplantation in advanced stages of the disease. Early intervention with Intacs may also limit the development of corneal scarring associated with contact lens use.…”

European clinical evaluation: Use of Intacs for the treatment of keratoconus

“…Results from preliminary studies indicate that Intacs seem to allow better quality of vision in patients with advanced keratoconus, may permit refitting these patients with contact lenses, and may delay or eliminate the need for a corneal transplant procedure. 23 …”

Intrastromal corneal ring segments: Effect of relationship between alignment and topographic keratometric meridians

“…7,8,[13][14][15][16][17] The meridian chosen for the incision site has been defined in relation to the location of the positive refractive cylinder axis or the keratometric steep meridian. 17 From earlier studies in which the 14 surgeons have continued to modify their approaches to improve outcomes.…”