Intacs are implantable intracorneal ring segments (also known as ICRS). This is a procedure which may be helpful for patients with keratoconus or corneal optical irregularities such as ectasia after other surgeries. Intacs were originally FDA-approved, in some situations, to correct low degrees of nearsightedness. In 2004, Intacs were approved by the FDA for the treatment of keratoconus. Results of Intacs for keratoconus treatment have been encouraging, especially in patients unable to tolerate contact lenses or in need of a corneal transplant.
Intacs are two small crescents of a contact lens-like material (PMMA). Unlike procedures such as LASIK, Intacs are implanted into the outer edge of the cornea so that the center of the cornea remains untouched. The insertion of Intacs causes the cornea to generally flatten. In addition, Intacs tend to decrease the irregular astigmatism found in keratoconus Intacs can be safely removed if necessary. In such cases, the cornea will generally return to its preoperative condition.
The primary goal of Intacs in keratoconus is to make the eye again tolerant of contact lenses and to avoid corneal transplantation. Other goals are to improve vision with glasses as well as uncorrected vision (without glasses or contact lenses). The goal of Intacs varies with the severity of your problem
At the beginning of the procedure, topical numbing drops are applied. A lid holder supports your lids to avoid blinking during the procedure. A channel within the cornea is then prepared, into which the Intacs will be inserted. This step is done with a laser called an Intralase or with a special intracorneal tunneling instrument. We generally prefer the Intralase technique, finding a more robust result in patients treated in this way. However, the ultimate selection of technique depends on your particular situation. In either case, a suction ring is placed to stabilize the eye, the channel is prepared for the Intacs, and then the Intacs are inserted. Some patients may have 2 Intacs placed, others may have only one placed depending on the individual cornea. At the end of the procedure, a stitch or contact lens bandage is placed, eyedrops are given, and a clear plastic shield is applied for protection. You will use eyedrops to avoid infection and inflammation for 1 week.
Vision begins to improve the day after the procedure but may fluctuate for several days. Most people can return to work one to two days after the procedure. During your followup examinations, we will determine if additional procedures may be beneficial. These include changing Intacs size or position, adding supplemental procedures such as CK, and other techniques. Keep in mind that Intacs is not necessarily a one-time procedure. Further treatment might be necessary over the months after your surgery to enhance and optimize the final result.
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