INTACS – PKP ComparisonINTACS – PKP Comparison

+8.00 X -2.00 X 180°-0.75

TransplantIntacs

Current Surgical Options - Keratoconus

Current Surgical Options - Keratoconus

10% to 20% of Keratoconus Patients Ultimately Require Surgery

Lamellar Keratoplasty

• Interface haze limits visual result

Penetrating Keratoplasty

• Most frequent procedure – 4,771 cases in 2004 (US)

• 80-90% successful

• Issues Graft rejection rate 17.9% Continued astigmatism Endothelial cell loss (limited longevity of graft) Recurrence of Keratoconus

Surgical: Central Endothelial Cell Density

Studies

Normal: 0.3% - 1.0% Cell loss/Year

PRK: 1.6% - 9.0% Cell loss/Year

LASIK: 0.1% - 1.0% Cell loss/Year INTACS: 0.2% - 0.5% Cell loss/Year

CORRECTIVE SURGERY: Central Endothelial Cell

Density Studies

Cataract: 2.5% Cell loss/Year Keratoplasty: 7.8% Cell loss/Year

INTACS - PKP ComparisonINTACS - PKP ComparisonPKP

Irreversible Procedure Time: 1 Hour Rehab Time: 12-18

Months

Intraocular Procedure Lifetime Follow-up Complications

• Cataract, Glaucoma• Endophthalmitis• Rejection• Expulsive hemorrhage• Corneal ulcer• Neovascularization• Induced astigmatism• Disease recurrence• Risk of viral transference

INTACS Removable Out-Patient

Procedure Time: 20-30 Minutes Rehab Time: 1-2 Weeks

(Visual Function Immediate)

Corneal Lamellar Procedure Periodic Follow-up Complications

• Unsatisfactory ring placement• Segment extrusion• Infection(Easily managed with segment

removal)

INTACS - PKP ComparisonINTACS - PKP Comparison

PKP

Significant loss of endothelial cells

Permanently weakened cornea with risk of additional trauma

Outcomes: unpredictable, often unstable

INTACS

Endothelial cell loss, not clinically significant1

Provides structural integrity, PKP still an option without complication

Outcomes: predictable, case dependent

1Two-Tear Endothelial Cell Assessment following INTACS implantation, Azaretal, J Refract Surg. 2001 Sept-Oct

Conclusions: INTACS Intervention Superior to

Transplant

Conclusions: INTACS Intervention Superior to

Transplant INTACS restore functional vision

• Functional refraction with soft, soft-toric, or rigid contact lenses is likely

• Creates cornea more receptive to contact lenses

INTACS reduce corneal coning• Central cone is flattened• Asymmetrical cones are repositioned centrally

INTACS post-surgical recovery• Visual improvement can be immediate • Vision stabilizes in months rather than a year or longer

High potential to defer transplant