INTACS or Intra-Corneal Rings

INTACS are a relatively new emergence in the field of eye surgery. They are colourless semi-circular clips made from a special type of plastic that are inserted into the cornea, around the sides. Once inserted they cannot be seen or felt and can be removed or replaced whenever (they usually never need replacing). They work by reshaping and strengthening the cornea from the surface. There is no cutting or tissue removal involved.

What do INTACS treat?

There are a number of conditions amenable to treatment with INTACS. The first type of problem that is treated with INTACS is myopia or short sightedness. The INTACS are added into the peripheral areas of the cornea, to help stretch it, flattening it out. This decreases the refractive power of the eye, allowing someone who is short sighted to see objects from far away. This procedure is advantageous as it does not remove any tissue from the cornea, preventing the occurence of side effects following the procedure.

The second complaint that can be treated with INTACS is Keratoconus. This is a problem that arises when the cornea is too thin, or the pressure within the eye is too great. The combination of the two causes the cornea to bulge outwards, resembling a cone shape. This causes problems such as short sightedness and even astigmatism. The usual treatment for keratoconus is the use of rigid so called toric contact lenses. These flatten the bulging cornea, helping to focus the images that were previously blurry. For them to work properly, they must fit well so that they don’t cause any irritation or scarring. Patients who were unsuitable for wearing these rigid contact lenses were previously given corneal transplants, which has a number of associated side effects and complications. With the advent of INTACS many patients who were unable to wear contact lenses are now able to use the INTACS to correct their vision without needing a transplant. They can also be left in if a corneal transplant is required.

The last problem that can be treated with INTACS is Corneal Ectasia. This is usually the result of a previous poor refractive procedure that has removed too much tissue from the cornea. This then causes short sightedness just like keratoconus and can be treated in the same way, either with rigid contact lenses or INTACS.

How are INTACS inserted?

The insertion of INTACS is relatively simple and can be done in an outpatients clinic. As usual anaesthetic eye drops are used to numb your eye and prevent any pain. Once your eyelids have been held back, the ophthalmologist will make a number of incisions around the peripheral aspect of your cornea, where they can then insert the INTACS, just under the cornea. These then stick into the cornea, helping to strengthen it and correct your vision. To help them stay in your eye, the surgeon will add a number of stitches which you may find irritate your eye.

How long does recovery take after INTACS surgery?

You will be given different eye drops to add into your eye over the coming few weeks, not only to help prevent infection, but also to help decrease any irritation you may experience. The stitches will be removed after a couple of weeks, when your cornea has healed up.

If you had the surgery to correct short sightedness, you should expect your vision to be corrected straight away, however if it was for keratoconus or corneal ectasia it may take a few months. During this period you will be required to visit the doctor on regular occasions to make sure your cornea is healing effectively. You may find that when your eye is recovering you are very sensitive to light and you have problems seeing at night. This is common and will fade.

What are the advantages to INTACS?

The main advantages to having INTACS inserted are that they are immediate and no tissue is removed, they can also be changed if your vision does. This decreases the risk of developing serious side effects and complications such as night time starbursts and glare. You will also feel no pain in the procedure as the INTACS are inserted into a layer of the cornea that has no pain receptors.

Am I suitable for INTACS?

As the INTACS are inserted into the cornea they cannot cure very severe eye conditions. As such there are guidelines as to who is eligible for INTACS. These are,

Your prescription must be between 1 and 3 dioptres, and not more than 1 if you have astigmatism

  • You must be over 21
  • You must not have any autoimmune disease, this can prevent your eye from healing
  • You must be healthy and not pregnant
  • You must not be using insulin or drugs that can prevent your cornea from healing

What are the risks with INTACS?

As with all the other types of eye surgery there are risks and complications that can occur. These are typical and include over and under correction, dry eye, infection and sensitivity to light.

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