117
16 INTACS
®
implantation
16 INTACS
®
implantation
16.1 Case 1: INTACS
®
implantation
by Prof. Michael W. Belin
A 27-year-old female was referred by her optometrist because of poor vision OD secondary to
keratoconus. Her BSCVA was 20/200 OD and with RGP over-refraction 20/30. The patient complained
of poor contact lens tolerance with less than 3 hours of daily wearing time. The patient was being
considered for intrastromal corneal ring segment implantation (ICRS, commonly referred to as
INTACS® in the US)
Anterior corneal curvature analysis showed significant inferior cone displacement and a maximum
steepness of > 50 D, with the steepest part of the cone well below the pupillary margin
(Figure 144)
.
A presumptive diagnosis of pellucid marginal degeneration (PMD) was made, and the initial surgical
plan was to implant dissimilar INTACS® for PMD.
Surgical planning also included identifying the steep axis for the incision and looking at the
pachymetry over the incision location to determine the incision depth
(Figure 145)
.
Surgical planning included:
implantation of 0.35 INTACS®
incision at axis 155°
incision depth 440 μm
Figure 144: Topography in a case of suspected PMD
