1. Evaluation of Efficacy and Safety of Intracorneal Ring Segment (Intacs SK) in Keratoconus Abdulrahman Al-Muammar, MD, FRCSC I have no financial interest in any of the materials presented

2. Purpose To examine the safety and efficacy of Intacs SK in the treatment of mild, moderate and severe keratoconus

3. Methods Retrospective study to evaluate the refractive and visual outcome of 25 keratoconic eyes of 20 patients with varying severity ranging from grade I to IV on Amsler-Krumeich’s classification All eyes had at least 12 months follow up All eyes underwent Intacs SK (thickness 210 to 450 µm) implantations using the manufacture’s new nomogram based on corneal topography, sphere, cylinder and spherical equivalent

4. Methods Similar surgical procedure was used in all cases using manual dissector Study parameters included: – UCVA – BCVA – Manifest refraction – Topography keratometry readings Follow up 3,6 and 12 month then every 6 months

5. Demography number25 eye AGE(57-18) AVERAGE 28.25 SEX9 Male _ 16 Female EYE5 Bilateral _15 Unilateral SHERE(-17.75_3.50) CYLINDER(-6.25 _ -1.25) SEPHERICAL EQUVELNET (-19.75_ 1.5) STEEP K(43.3_57.6) FLAT K(38_53.7) AVERAGE K(40.2-55.2)

6. Results

10. Safety and efficacy

11. Complications No segment extrusion Wound gap was noted in one eye No perforation No keratitis Corneal deposits were seen in 10 eyes

12. Conclusion At post-operative month 12, there was significant improvement in UCVA, BCVA, sphere, spherical equivalent and Av K from the pre-operative values No eyes lost any lines of UCVA or BCVA Intacs SK implantation is safe and effective in mild, moderate and severe keratoconus

13. Intacs SK versus Intacs regular in mild to moderate keratoconus 17 keratoconic eyes ( I to II) treated with Intacs SK with 12 months follow up were compared to 17 keratoconic eye (I to II) treated with Intacs regular with 12 months follow up

14. Results

18. Conclusion Outcome of Intacs SK and regular in Keratoconic eyes (I to II) were comparable in terms of UCVA, cylinder, spherical equivalent and Av K BCVA was significantly better in Intacs SK group pro- operatively and post-operatively Regression was noted between 6 and 12 months follow up in sphere, cylinder, SE and K readings in both groups which may indicate disease progression

19. Thank you… Thank you…