eMedicine Specialties > Ophthalmology > Refractive Disorders

Myopia, Intracorneal Rings: Multimedia

Author: Manolette R Roque, MD, MBA, DPBO, FPAO, President and CEO, Chief of Service, Ocular Immunology and Uveitis, Consulting Staff, Cornea and Refractive Surgery, Eye Republic Ophthalmology Clinic; General Manager, Ophthalmic Consultants Philippines Co; Consulting Staff, CME Liaison, Section Chief of Ocular Immunology and Uveitis, Department of Ophthalmology, Asian Hospital and Medical Center
Coauthor(s): Barbara L Roque, MD, Full Partner, Ophthalmic Consultants Philippines Co, Chief of Service, Pediatric Ophthalmology and Strabismus, Consulting Staff, Orbit and Eye Plastics, Eye Republic Ophthalmology Clinic; Ruben Limbonsiong, MD, Chief of Service, Refractive Surgery Service and Vision Laser Center, St. Luke's Medical Center; Program Director, Clinical Assistant Professor, Department of Ophthalmology, University of the Philippines at Manila; Roberto Pineda, ll, MD, Scholar, The Academy at Harvard Medical School; Director, Refractive Surgery Service, Massachusetts Eye and Ear Infirmary
Contributor Information and Disclosures

Updated: Dec 19, 2008

Multimedia

KeraVision Intacs microthin prescription inserts....
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Media file 1: KeraVision Intacs microthin prescription inserts. Reprinted with permission of Addition Technology Inc.
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KeraVision Intacs microthin prescription inserts....

KeraVision Intacs microthin prescription inserts. Reprinted with permission of Addition Technology Inc.

KeraVision Intacs microthin prescription inserts....
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Media file 2: KeraVision Intacs microthin prescription inserts. Intracorneal ring segments. Reprinted with permission of Addition Technology Inc.
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KeraVision Intacs microthin prescription inserts....

KeraVision Intacs microthin prescription inserts. Intracorneal ring segments. Reprinted with permission of Addition Technology Inc.

The 1.2-mm radial incision is made with a diamond...
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Media file 3: The 1.2-mm radial incision is made with a diamond knife at the edge of a 7-mm optical zone. The diamond knife is set for approximately two thirds of corneal depth. Reprinted with permission of Addition Technology Inc.
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The 1.2-mm radial incision is made with a diamond...

The 1.2-mm radial incision is made with a diamond knife at the edge of a 7-mm optical zone. The diamond knife is set for approximately two thirds of corneal depth. Reprinted with permission of Addition Technology Inc.

Rotation of the dissector creates the tunnel in t...
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Media file 4: Rotation of the dissector creates the tunnel in the peripheral cornea into which an Intacs insert will be placed. Reprinted with permission of Addition Technology Inc.
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Rotation of the dissector creates the tunnel in t...

Rotation of the dissector creates the tunnel in the peripheral cornea into which an Intacs insert will be placed. Reprinted with permission of Addition Technology Inc.

The first Intacs insert is placed in the tunnel. ...
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Media file 5: The first Intacs insert is placed in the tunnel. Reprinted with permission of Addition Technology Inc.
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The first Intacs insert is placed in the tunnel. ...

The first Intacs insert is placed in the tunnel. Reprinted with permission of Addition Technology Inc.

An Intacs insert in place at approximately two th...
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Media file 6: An Intacs insert in place at approximately two thirds of corneal depth. Reprinted with permission of Addition Technology Inc.
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An Intacs insert in place at approximately two th...

An Intacs insert in place at approximately two thirds of corneal depth. Reprinted with permission of Addition Technology Inc.

Graphic representation of the intracorneal ring s...
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Media file 7: Graphic representation of the intracorneal ring segments in place. Reprinted with permission of Addition Technology Inc.
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Graphic representation of the intracorneal ring s...

Graphic representation of the intracorneal ring segments in place. Reprinted with permission of Addition Technology Inc.

Intacs microthin prescription inserts treat mild ...
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Media file 8: Intacs microthin prescription inserts treat mild myopia. Reprinted with permission of Addition Technology Inc.
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Intacs microthin prescription inserts treat mild ...

Intacs microthin prescription inserts treat mild myopia. Reprinted with permission of Addition Technology Inc.

More on Myopia, Intracorneal Rings

Overview: Myopia, Intracorneal Rings
Workup: Myopia, Intracorneal Rings
Treatment: Myopia, Intracorneal Rings
Follow-up: Myopia, Intracorneal Rings
Multimedia: Myopia, Intracorneal Rings
References
Further Reading
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References

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  2. Alió JL, Artola A, Hassanein A, et al. One or 2 Intacs segments for the correction of keratoconus. J Cataract Refract Surg. May 2005;31(5):943-53. [Medline].

  3. Asbell PA, Ucakhan OO. Long-term follow-up of Intacs from a single center. J Cataract Refract Surg. Sep 2001;27(9):1456-68. [Medline].

  4. Asbell PA, Ucakhan OO, Durrie DS, et al. Adjustability of refractive effect for corneal ring segments. J Refract Surg. Nov-Dec 1999;15(6):627-31. [Medline].

  5. Assil KK. Intacs as an Enhancement Procedure. In: AAO Refractive Surgery Subspecialty Day Manual. 2000.

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  7. Assil KK, Quantock AJ, Barrett AM, et al. Corneal iron lines associated with the intrastromal corneal ring. Am J Ophthalmol. Sep 15 1993;116(3):350-6. [Medline].

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  28. Donnenfeld ED. Intacs vs LASIK for Low Myopia. In: AAO Refractive Surgery Subspecialty Day Manual. 2000.

  29. Duffey RJ, Leaming D. U.S. trends in refractive surgery: 2001 International Society of Refractive Surgery Survey. J Refract Surg. Mar-Apr 2002;18(2):185-8. [Medline].

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  33. Ertan A, Kamburoglu G. Intacs implantation using a femtosecond laser for management of keratoconus: Comparison of 306 cases in different stages. J Cataract Refract Surg. Sep 2008;34(9):1521-6. [Medline].

  34. FDA. Intacs. Summary of safety and effectiveness. FDA. 1999.

  35. Fleming JF, Lovisolo CF. Intrastromal corneal ring segments in a patient with previous laser in situ keratomileusis. J Refract Surg. May-Jun 2000;16(3):365-7. [Medline].

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  37. Fontana L, Parente G, Sincich A, Tassinari G. Deep anterior lamellar keratoplasty after intacs implantation in patients with keratoconus. Cornea. Jan 2009;28(1):32-5. [Medline].

  38. Gomez L, Chayet A. Laser in situ keratomileusis results after intrastromal corneal ring segments (Intacs). Ophthalmology. Oct 2001;108(10):1738-43. [Medline].

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  41. Guell JL, Velasco F, Sanchez SI, et al. Intracorneal ring segments after laser in situ keratomileusis. J Refract Surg. Jul-Aug 2004;20(4):349-55. [Medline].

  42. Harr D. KeraVision begins implanting corneal reshaping device in blind eyes. Refract Corneal Surg. Sep-Oct 1991;7(5):343. [Medline].

  43. Hellstedt T, Makela J, Uusitalo R, et al. Treating keratoconus with intacs corneal ring segments. J Refract Surg. May-Jun 2005;21(3):236-46. [Medline].

  44. Hofling-Lima AL, Branco BC, Romano AC, et al. Corneal infections after implantation of intracorneal ring segments. Cornea. Aug 2004;23(6):547-9. [Medline].

  45. Holmes-Higgin DK, Baker PC, Burris TE, et al. Characterization of the aspheric corneal surface with intrastromal corneal ring segments. J Refract Surg. Sep-Oct 1999;15(5):520-8. [Medline].

  46. Holmes-Higgin DK, Burris TE. Corneal surface topography and associated visual performance with INTACS for myopia: phase III clinical trial results. The INTACS Study Group. Ophthalmology. Nov 2000;107(11):2061-71. [Medline].

  47. Holmes-Higgin DK, Burris TE, Lapidus JA, et al. Risk factors for self-reported visual symptoms with Intacs inserts for myopia. Ophthalmology. Jan 2002;109(1):46-56. [Medline].

  48. Ito M, Arai H, Fukumoto T, et al. INTACS before or after laser in situ keratomileusis: correction of thin corneas with moderately high myopia. J Refract Surg. Nov-Dec 2004;20(6):818-22. [Medline].

  49. Kamburoglu G, Ertan A. Intacs implantation with sequential collagen cross-linking treatment in postoperative LASIK ectasia. J Refract Surg. Sep 2008;24(7):S726-9. [Medline].

  50. Kessler D, El-Shiaty AF, Wachler BS. Evaluation of tear film following Intacs for myopia. J Refract Surg. Mar-Apr 2002;18(2):127-9. [Medline].

  51. Kymionis GD, Aslanides IM, Siganos CS, et al. Intacs for early pellucid marginal degeneration. J Cataract Refract Surg. Jan 2004;30(1):230-3. [Medline].

  52. Kymionis GD, Siganos CS, Kounis G, et al. Management of post-LASIK corneal ectasia with Intacs inserts: one-year results. Arch Ophthalmol. Mar 2003;121(3):322-6. [Medline].

  53. Levinger S, Pokroy R. Keratoconus managed with intacs: one-year results. Arch Ophthalmol. Oct 2005;123(10):1308-14. [Medline].

  54. Linebarger EJ, Song D, Ruckhofer J, et al. Intacs: the intrastromal corneal ring. Int Ophthalmol Clin. Summer 2000;40(3):199-208. [Medline].

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  56. Loughnan MS, Robinson D, Sullivan L. Mechanical methods in refractive corneal surgery. Curr Opin Ophthalmol. Aug 1996;7(4):41-6. [Medline].

  57. Lovisolo CF, Fleming JF. Intracorneal ring segments for iatrogenic keratectasia after laser in situ keratomileusis or photorefractive keratectomy. J Refract Surg. Sep-Oct 2002;18(5):535-41. [Medline].

  58. McDonald JE, Deitz DJ. Removal of Intacs with a fractured positioning hole. J Refract Surg. Mar-Apr 2004;20(2):182-3. [Medline].

  59. Mularoni A, Torreggiani A, di Biase A, et al. Conservative treatment of early and moderate pellucid marginal degeneration: a new refractive approach with intracorneal rings. Ophthalmology. Apr 2005;112(4):660-6. [Medline].

  60. Nio YK, Jansonius NM, Wijdh RH, et al. Effect of methods of myopia correction on visual acuity, contrast sensitivity, and depth of focus. J Cataract Refract Surg. Nov 2003;29(11):2082-95. [Medline].

  61. Nose W, Neves RA, Burris TE, et al. Intrastromal corneal ring: 12-month sighted myopic eyes. J Refract Surg. Jan-Feb 1996;12(1):20-8. [Medline].

  62. Nosé W, Neves RA, Schanzlin DJ, et al. Intrastromal corneal ring--one-year results of first implants in humans: a preliminary nonfunctional eye study. Refract Corneal Surg. Nov-Dec 1993;9(6):452-8. [Medline].

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  64. Pokroy R, Levinger S, Hirsh A. Single Intacs segment for post-laser in situ keratomileusis keratectasia. J Cataract Refract Surg. Aug 2004;30(8):1685-95. [Medline].

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  66. Rapuano CJ, Sugar A, Koch DD, et al. Intrastromal corneal ring segments for low myopia: a report by the American Academy of Ophthalmology. Ophthalmology. Oct 2001;108(10):1922-8. [Medline].

  67. Rodriguez-Prats J, Galal A, Garcia-Lledo M, et al. Intracorneal rings for the correction of pellucid marginal degeneration. J Cataract Refract Surg. Jul 2003;29(7):1421-4. [Medline].

  68. Rosen E, Kowalewski E. Instrument for initiating the corneal intrastromal channel for the insertion of Intacs. J Cataract Refract Surg. Sep 2001;27(9):1356-8. [Medline].

  69. Ruckhofer J, Bohnke M, Alzner E, et al. Confocal microscopy after implantation of intrastromal corneal ring segments. Ophthalmology. Dec 2000;107(12):2144-51. [Medline].

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  74. Shetty R, Kurian M, Anand D, Mhaske P, Narayana KM, Shetty BK. Intacs in advanced keratoconus. Cornea. Oct 2008;27(9):1022-9. [Medline].

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  76. Siganos CS, Kymionis GD, Kartakis N, et al. Management of keratoconus with Intacs. Am J Ophthalmol. Jan 2003;135(1):64-70. [Medline].

  77. Sugar A. Correction of spherical myopia with a single 150-degree intrastromal corneal ring segment. J Cataract Refract Surg. May 2004;30(5):1127-9. [Medline].

  78. Tran DB, Zadok D, Carpenter M, et al. Intraocular pressure measurement in patients with intrastromal corneal ring segments. J Refract Surg. Jul-Aug 1999;15(4):441-3. [Medline].

  79. Twa MD, Hurst TJ, Walker JG, et al. Diurnal stability of refraction after implantation with intracorneal ring segments. J Cataract Refract Surg. Apr 2000;26(4):516-23. [Medline].

  80. Twa MD, Karpecki PM, King BJ, et al. One-year results from the phase III investigation of the KeraVision Intacs. J Am Optom Assoc. Aug 1999;70(8):515-24. [Medline].

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Further Reading

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Keywords

Intacs microthin prescription inserts, Intacs, Intacs inserts, intracorneal rings, intrastromal corneal rings, ICR, intrastromal corneal ring segments, ICRS, refractive keratotomy, RK, photorefractive keratectomy, PRK, laser-assisted in situ keratomileusis, LASIK, myopia, astigmatism, refractive surgery, keratoconus

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Contributor Information and Disclosures

Author

Manolette R Roque, MD, MBA, DPBO, FPAO, President and CEO, Chief of Service, Ocular Immunology and Uveitis, Consulting Staff, Cornea and Refractive Surgery, Eye Republic Ophthalmology Clinic; General Manager, Ophthalmic Consultants Philippines Co; Consulting Staff, CME Liaison, Section Chief of Ocular Immunology and Uveitis, Department of Ophthalmology, Asian Hospital and Medical Center
Manolette R Roque, MD, MBA, DPBO, FPAO is a member of the following medical societies: American Academy of Ophthalmic Executives, American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, American Society of Ophthalmic Administrators, American Uveitis Society, International Ocular Inflammation Society, Philippine Medical Association, Philippine Ocular Inflammation Society, and Philippine Society of Cataract and Refractive Surgery
Disclosure: Nothing to disclose.

Coauthor(s)

Barbara L Roque, MD, Full Partner, Ophthalmic Consultants Philippines Co, Chief of Service, Pediatric Ophthalmology and Strabismus, Consulting Staff, Orbit and Eye Plastics, Eye Republic Ophthalmology Clinic
Disclosure: Nothing to disclose.

Ruben Limbonsiong, MD, Chief of Service, Refractive Surgery Service and Vision Laser Center, St. Luke's Medical Center; Program Director, Clinical Assistant Professor, Department of Ophthalmology, University of the Philippines at Manila
Ruben Limbonsiong, MD is a member of the following medical societies: American Academy of Ophthalmology and American Society of Cataract and Refractive Surgery
Disclosure: Nothing to disclose.

Roberto Pineda, ll, MD, Scholar, The Academy at Harvard Medical School; Director, Refractive Surgery Service, Massachusetts Eye and Ear Infirmary
Roberto Pineda, ll, MD is a member of the following medical societies: American Academy of Ophthalmology and American Society of Cataract and Refractive Surgery
Disclosure: Nothing to disclose.

Medical Editor

Daniel S Durrie, MD, Director, Department of Ophthalmology, Division of Refractive Surgery, University of Kansas Medical Center
Daniel S Durrie, MD is a member of the following medical societies: American Academy of Ophthalmology and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Louis E Probst, MD, Medical Director of Refractive Surgery, Chicago, Madison, Milwaukee, and Windsor Centers, TLC the Laser Eye Centers
Louis E Probst, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, and International Society of Refractive Surgery
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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