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Should You Have Intacs™?
By Joseph F. Fleming, M.D.


Whether for keratoconus, for problems after LASIK, or simply for nearsightedness, Intacs™ is a modern surgical procedure deserving your consideration. Intacs™, also known as intracorneal ring segments, can usually be done in the office using only eyedrops for anesthesia. The procedure involves implantation of two small arcs of special plastic in the eye's cornea (the clear front window of the eye). The presence of the ring segments slightly alters corneal shape allowing the correction of nearsightedness or smoothing of eyes with keratoconus. Intacs™ has been FDA approved for treatment of nearsightedness since 1999, and it has been used "off-label" to treat keratoconus and for treatment of problems experienced by some after LASIK.

Keratoconus is an eye disease that results in an irregular shape of the eye's cornea. The irregularity degrades the optical properties of the eye and can make good vision difficult even with contact lenses or glasses. The Intacs™ procedure has been widely accepted in in the field of eye surgery as an effective treatment for keratoconus. The Intacs™ segments usually help smooth the irregular corneal surface resulting from keratoconus. Many insurance companies now pay for Intacs™ in keratonconus.

After Lasik, some patients have problems. Intacs™ may be helpful in the treatment of these problems in some instances. Ectasia is a problem that occurs in rare instances after LASIK. The cornea can become irregular and misshapen. Intacs™ can be used to help smooth the cornea and improve visual function in patients with ectasia. A more common problem after LASIK is undercorrection or residual nearsightedness. This happens if the laser procedure leaves some nearsightedness behind. Often this residual nearsightedness can be corrected with a second laser treatment, but in some cases this may not be possible. If a laser retreatment cannot be done, Intacs™ may be used to correct the residual nearsightedness in hopes of fully eliminating the need for glasses.

Intacs™ has been used extensively for treatment of nearsightedness. The goal is to free the nearsighted individual from dependence on glasses or contact lenses. The success rate is similar to that of LASIK, and the FDA has determined that Intacs™ surgery is safe and effective for treatment of nearsightedness. The Intacs™ procedure has a unique advantage over the laser procedure (which creates a permanent change in corneal shape). While Intacs™ provides a permanent visual correction, the Intacs™ segments may be removed if desired (with reversal of the refractive effect).