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Intracorneal Rings (ICRs) are plastic inserts placed in the cornea. The rings flatten the central cornea to correct low levels of nearsightedness (myopia). Unlike other refractive surgery procedures, intracorneal rings can be removed. When the inserts are removed the cornea returns to its preoperative shape and one is again nearsighted. The procedure is generally performed on an outpatient basis using drops for an anesthetic.

It is a quick procedure and can take less than half an hour. Research is being done on intracorneal rings to correct farsightedness and astigmatism. Complications with intracorneal rings are rare, but include undercorrection, overcorrection, induced astigmatism, infection, glare, haloes and extrusion of the insert. Minimal scarring may also occur in the area of the rings.

For people with low degrees of myopia (-1 to -2.75 diopters), intracorneal ring segments offer an attractive alternative to LASIK. The plastic Intac rings do not disturb the central visual axis of the cornea. They also offer the advantage of being removable. Ask about this new option for mild myopia. This procedure is also under investigation for both farsightedness and mild astigmatism.

Intacs/corneal ring segments are the revolutionary way to correct mild nearsightedness -- without laser surgery. They provide an alternative to eyeglasses, contact lenses, and surgical procedures that permanently alter the eye by cutting or removing tissue from the central cornea.

Intacs are two tiny half rings. To get an idea of how small they are, just imagine a contact lens where the center part has been removed and only the very outer edge remains; then imagine this ring divided into two equal halves. That's how tiny Intacs are.

Intacs are made of a special biocompatible plastic that has been safely used for nearly 50 years in contact lenses and in the intraocular lenses used to treat patients with cataracts. Intacs are designed for permanent placement in the eye, but they are also removable.

When placed in the periphery of the cornea, they are practically invisible-and they cannot be felt. Intacs reshape corneal curvature without removing tissue from the central optical zone, the area of the cornea that is most critical for clear vision. This subtle reshaping makes nearsighted corneas flatter, thereby correcting vision.

Intacs are the result of nearly a decade of clinical research and have been available in other countries for several years.

Simply put, Intacs gently change the shape of your cornea to correct your vision. In the nearsighted eye, the curve of the cornea is too steep. Light rays entering the eye are bent too much and are focused in front of the retina -- instead of on it. As a result, things far away appear blurry. Intacs change the shape of the cornea, allowing the light rays to focus on the retina. But unlike laser surgery, which reshapes the cornea by removing tissue from the center, Intacs are placed in the outer edge -- leaving the central optical zone intact.

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What are the advantages of Intacs?

Intacs offer several key advantages:

Intacs are a safe and effective means of correcting mild nearsightedness.
Intacs are FDA-approved.
Intacs offer an immediate improvement in vision.
Intacs provide excellent results. In U.S. clinical studies, 97% of patients saw 20/40 or better with Intacs, 74% saw 20/20 or better, and 53% saw 20/16 or better.
Intacs are maintenance-free.
Tissue is not removed from the central optical zone (the region of the cornea most important for clear vision).
Intacs offer greater flexibility because they can be removed or replaced.

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Who is a candidate for Intacs?

Intacs are currently available for people with mild myopia (nearsightedness) who have no more than 1.00 diopter of astigmatism. The best way to find out if you are a candidate for the procedure is to schedule an appointment with your doctor so he can evaluate your vision.

You may qualify for Intacs if:

Your prescription for eyeglasses or contacts is between -1.00 and -3.00 diopters with no more than 1.00 diopter of astigmatism;
You have healthy eyes, free from disease and injuries;
You have had stable vision for at least one year;
You are at least 21 years of age.

Who is not a candidate for Intacs?

You should not have Intacs placed if:

You have autoimmune or immunodeficiency diseases (lupus, rheumatoid arthritis or AIDS, for example);
You are pregnant or nursing;
You have known conditions of the eye that may increase the possibility of future problems;
You are taking prescription medications that may affect corneal healing or your vision.

Your doctor will review your medical history with you and evaluate your eyes for any conditions that might suggest you should not get Intacs. It is important to advise your surgeon if you have had a Herpes infection in your eyes, if you have insulin dependent diabetes, or if you have any other medical condition that might affect wound healing. You should also bring a list of any prescription and over-the-counter medicines that you take.

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Your Ophthalmologist, who has received special training in the placement of Intacs, will perform the procedure. The procedure will generally be performed in the office operating room.

Typically, patients are given a mild oral sedative and eye drops to numb the eye before the procedure. A tiny opening, less than 2 mm, is made near the upper edge of the cornea beneath the eyelid. Intacs are inserted through this opening so that they rest between the layers of tissue in the cornea, outside the central optical zone. This procedure usually takes about 15 minutes and is performed on an outpatient basis.

As with any refractive surgical procedure, there are certain risks and complications. Clinical studies in the U.S. showed that infection, which is a risk in any surgical procedure, occurred 0.2% of the time following the placement of Intacs. Other adverse events included: shallow Intacs placement (0.2%); temporary loss of 2 lines of best corrected vision (0.2%) and anterior chamber perforation during surgery (0.4%). None of these events resulted in a permanent loss of vision. Other complications included: overcorrection, reduction in central corneal sensation, difficulty with night vision, undercorrection, induced astigmatism, blurry vision, double vision, corneal blood vessels, halos, glare, fluctuating distance vision and a reduction of 2 or more lines of best corrected vision.

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Intacs are not felt because they are placed in the cornea beneath the nerve endings. The majority of patients notice significantly improved vision the first day after surgery. Most people resume normal activities within two or three days. Intacs are intended to remain permanently in place without maintenance, yet a trained ophthalmic surgeon can easily remove them.

In U.S. clinical studies, 97% of patients saw 20/40 or better with Intacs; 74% saw 20/20 or better (the standard for good vision), and 53% saw 20/16 or better (a level that exceeds the standard for good vision). To better understand what your potential results might be, an eye exam and consultation will be necessary.

If the results of the procedure are not satisfactory, you may need to have your Intacs removed or replaced. A doctor trained in the procedure will be happy to discuss the potential risks and benefits in detail with you.

As you get older, your eyesight will change. If the Intacs you were given no longer provide the amount of correction you need, they may be removed or replaced. Your doctor will help you determine the best means to accommodate any changes in your vision. Check our news link for recent developements.