Case Study: February 2007

1. Look at Figures 1 and 2. Which procedure has this cornea been exposed to?

2. Why was the procedure done?

3. What are the specific complications of this procedure?

4. What are the indications for this procedure?

Click to show answers

1. Intrastromal corneal ring (INTACS) insertion.

2. For keratoconus-note the break in Bowman’s in Figure 3.

3. Difficulty with night vision, glare, halos, blurry or double vision and fluctuating distance vision.
Bacterial keratitis.
Crystalline keratopathy
Ring exposure.
Anterior chamber entry
Fractured positioning hole

4. Keratoconus and myopia. Intacs are made of the same materials as IOLs and work by flattening the corneal curvature.

Colin J, Malet FJ. Intacs for the correction of keratoconus: two-year follow-up.
J Cataract Refract Surg. 2007 Jan;33(1):69-74.

Samimi S, Leger F, Touboul D, Colin J. Histopathological findings after intracorneal ring segment implantation in keratoconic human corneas.
J Cataract Refract Surg. 2007 Feb;33(2):247-53.

Katsoulis K, Sarra GM, Schittny JC, Frueh BE.Bilateral central crystalline corneal deposits four years after intacs for myopia.
J Refract Surg. 2006 Nov;22(9):910-3.

Ly LT, McCulley JP, Verity SM, Cavanagh HD, Bowman RW, Petroll WM. Evaluation of intrastromal lipid deposits after intacs implantation using in vivo confocal microscopy.
Eye Contact Lens. 2006 Jul;32(4):211-5.