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Background. Since 1996 Intrastromal Corneal Ring Segments (Intacs, KeraVision,Inc.Fremont, Ca, USA) have been used for the correction of mild to moderate myopia at the Salzburg Eye Clinic. Aim of this study was to evaluate the stability, reversibility and adjustability for this new method. Patients and methods. Our experience and final results of 54 surgeries-30 eyes with a minimum follow-up of 2 years-as well as the potential reversibility (3 explantations, 2 of them followed by PRK) and adjustability (3 exchanges) are reported in detail. Results. None of the eyes lost more than one line in BSCVA(in 14 of 30 eyes the BSCVA improved). 73% (22/30) eyes reached an UCVA of 1.0 or better, 47% (14/30) eyes of 1.25 or better. After 2 years 47% (14/30) eyes were within +-0.5 DSPH of the attempted correction. We observed no significant intra or postoperative complications. After ICRS removal the refractive data returned within +- 0.75 Dsph (MRSE) and +- 0.5 Dsph (mean keratometry) of preoperative values, respectively. Patients with an ICRS exchange obtained an improved visual acuity between 0.8 and 1.0, gaining between 2 to 4 lines. Conclusions. With the follow-up period of 2 years the ICRS seem to provide a very stable correction of low to moderate myopia. The procedure is reversible to a large extent, potentially adjustable (within cartain limits) and carrie a minimal risk only. After explantation PRK can be performed with good visual results. Izhodišča. Intrastromalni roženični obročki ICRS (Intacs, KeraVision, Inc.Fremont, Ca, ZDA) se uporabljajo za korekcijo nizke do srednje kratkovidnosti na Očesni kliniki Salzburg od leta 1996. Namen študije je bila ocena stabilnosti, reverzibilnosti in prilagodljivosti te nove metode. Bolnikiin metode. Poročilo se nanaša na rezultate 54 posegov - 30 oči z najkrajšim sledenjem 2 leti, na potencirano reverzibilnost (3 eksplantacije, od tega je bila za tem pri dveh opravljena fotorefraktivna keratektomija-PRK) in prilagodljivost (3 zamenjave). Rezultati. Nobeno oko ni izgubilo več kot eno vrstico najbolje korigirane vidne ostrine (pri 14 od 30 oči se je ta celo izboljšala). 73% (22/30) oči je imelo vidno ostrino 1,0 ali več, 47% (14/30) oči pa 1,25 ali več. Po 2 letih je imelo 47% (14/30) oči želeno korekcijo znotraj +-0,5 dioptrije (Dsph). Ni bilo značilnih med- ali poperativnih zapletov. Po odstranitvi ICRS se je refrakcija povrnila na predoperativne vrednosti znotraj +- 0,75 Dsph (MRSE) in +-0,50 Dsph (povprečna keratometrija). Bolnikom po menjavi ICRS se je vidna ostrina izboljšala na 0,8-1,0, pridobili so 2 do 4 vrstice. Zaključki. Po 2-letnem sledenju se zdi, da nudijo ICRS stabilno korekcijo za nizko in srednjo kratkovidnost. Poseg je do velike mere reverzibilen, potencialno prilagodljiv in ima minimalno tveganje. Eksplantaciji lahko sledi PRK z dobro vidno ostrino. |
