Source: Oncology  |  Posted 10 years ago

By Cameron Johnston
Special to DG News
TORONTO, ON -- June 25, 2001 -- No difference in outcomes has been found for patients whose low myopia is treated with LASIK (laser in situ keratomileusis) eye surgery as compared with those who receive Intacs corneal ring segments, according to a study presented here at the Canadian Ophthalmological Society this week.
According to Dr. Guillermo Rocha, of the Brandon Health Sciences Centre, in Brandon, Manitoba, Canada, 12 patients with low myopia (1.00 to -4.25 dioptres) and minimal astigmatism (<1.00 D) were treated with LASIK and 12 were treated with Intacs corneal rings.
The researchers found no discernable difference in outcomes even after at least six months of follow-up.
At one month, all eyes in both groups had uncorrected visual acuity of 20/40 or better, whereas at three months, 83.3 percent of those treated with Intacs and 85.7 percent of those treated with LASIK had visual acuity of 20/20 or better.
All the patients had visual acuity of better than 20/40 at six months.
At one-month follow-up, none of the patients had a loss of more than one line of vision, while at six months, five patients who received Intacs and three who were treated with LASIK had a loss of one line of vision.
There were no complications in the LASIK group and one case of perforation in the Intacs group.
One patient in the Intacs group had to have both eyes re-treated because of under-correction. Over time, Dr. Rocha said, all of the patients with Intacs developed some degree of fibrosis, but this did not interfere with their vision. Some patients also reported some discomfort from the implants, although not enough to want the rings removed, he said.
Dr. Rocha noted that while long-term stability with LASIK has already been well demonstrated, there is not enough long-term data to say the same for Intacs.
However, he said, Intacs have an advantage in that the procedure can be reversed if the patient?s vision changes over time, or if for any other reason, the patient decides he or she does not want the corneal rings implanted.
"Both Intacs and LASIK are excellent options. LASIK achieves good results sooner, but Intacs patients are happier because they know that's the way they want to go, and so far, I have had no explants. The key is to be able to offer our refractive surgery patients these options."
The issue might come down to patients preference, that is, does the patient feel comfortable having the cornea sculpted by the LASIK procedure, or does the patient feel comfortable having the Intacs rings implanted in the cornea, Dr. Rocha said.
Ultimately, there are few medical indications that would steer the physician away from one procedure in favor of the other, although the physician has to be very much aware of corneal thickness and might elect not to use Intacs where there is abnormal corneal topography, he added.