Intacs Implantation With Sequential Collagen Cross-linking Treatment in Postoperative LASIK Ectasia

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Abstract
Purpose: To report the postoperative course and refractive results of each eye of a patient with postoperative LASIK ectasia for whom Intacs SK (severe keratoconus, Addition Technology Inc) implantation and collagen cross-linking (CXL) treatments were performed. Methods: A 27-year-old man with postoperative LASIK ectasia with best spectacle-corrected visual acuity (BSCVA) of 20/60 and 20/80 in the right and left eyes, respectively, was operated for Intacs SK implantation for both eyes. Spherical equivalent refraction and mean keratometric values in the right and left eyes were −14.50 diopters (D) and −10.50 D and 56.20 D and 50.70 D, respectively. Following bilateral Intacs SK implantation, CXL was performed after 1 day in the left eye and 1 month in the right eye. Results: During follow up, there was an improvement in visual acuity and decrease in manifest refraction and keratometric values in both eyes. A slight regression of these values was noted in the right eye 1 month after Intacs SK implantation, which was reversed by CXL. Eight months postoperatively, BSCVA was 20/25 and 20/25, manifest refractions were −1.50 ×170 and ×1.25 ×50, and mean keratometric values were 47.20 and 44.20 D in the right and left eyes, respectively. Conclusions: Intacs SK implantation and subsequent CXL may be alternatived in the treatment of postoperative LASIK ectasia. [ J Refract Surg . 2008;24: S726–S729.]

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