Purpose: To present 1-year data comparing the efficacy of the combination of CXL and INTACS vs CXL only in the treatment of keratoconus. Methods: The chart records of 25 eyes of 19 patients with keratoconus treated with CXL and INTACS between January 2011 and May 2013 were retrospectively reviewed. The outcomes of this combined procedure were compared with the outcomes of 143 eyes of 109 patients treated by CXL only. The following parameters were studied and outcomes were evaluated at 12 months postoperatively: uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), keratometry (Max K and Average K), and spherical equivalent. Results: Uncorrected visual acuity at 12 months following CXL+INTACS was significantly better than CXL only, in terms of lines gained. Uncorrected vision in the CXL+INTACS group improved by 1.7 lines more than in the CXL only group (p = 0.024). While the CXL+INTACS group, on average, gained 0.08 lines more than the CXL only group at 12 months postoperatively, this difference was not statistically significant (p = 0.1). The maximum keratometric value was significantly reduced by both CXL only and CXL+INTACS; however, there was, on average, a 2.45D greater flattening of K_MAX in the CXL+INTACS group when compared with the CXL only group (p = 0.00003). Conclusion: Both groups (CXL only and CXL+INTACS) demonstrated significant improvements in UCVA, BSCVA, and keratometry. However, there were statistically significant greater improvements in UCVA lines gained, keratometry, and spherical equivalent in the CXL+INTACS group compared with the CXL only group.

Aim: Evaluation of the changes in deformation amplitude (DA) ratio, integrated radius (IR), stress–strain index (SSI), and stiffness parameter at first applanation (SP-A1) obtained by the corneal visualization Scheimpflug technology (Corvis ST) and this is before and after different laser vision correction (LVC) procedures. Methods: An interventional study that is prospective, randomized, and comparative. Individuals having a maximum astigmatism of −3.00 D and a maximum [(mean refractive spherical equivalent (MRSE)] of −7.00 D. Using the Corvis ST, measurements were made of the DA ratio, IR, SSI, and SPA1 prior to and following three distinct LVC procedures: Photorefractive keratectomy (PRK; group I), laser assisted in situ keratomileusis (LASIK; group II), and Femto-LASIK (Femto-laser assisted in situ keratomileusis; group III). Results: Comparison between pre- and posttreatment showed significant increase in the DA ratio and IR with no significant change in SSI in group I. While in group II and III showed significant increase in DA ratio, IR and significant decrease in SSI. The SP-A1 change was significantly decreased in all three groups. Conclusion: The response of the corneal biomechanical to the three surgical procedures varied differently and the significant change was in the IR and SP-A1, where the SSI and DA ratio was nonsignificant. The results of LASIK and PRK showed the highest and lowest reductions in total corneal stiffness, respectively, while Femto-LASIK stayed in between.

The purpose of this paper is to describe a case of keratoconus with high hyperopia, a condition typically associated with high myopia. This case led to the diagnosis of nanophthalmos and possibly Leber's congenital amaurosis.