Intacs And Corneal Collagen Cross-linking, Two New But Effective

Procedures

Table of Content What is Intacs ? Intacs and Corneal Collagen. Post-operative care. Intacs and CK- the combined surgery. Corneal Collagen Cross-linking

procedure or CXL. The procedure. Conclusion.

What is Intacs ?

Intacs is the trademark name for micro-thin prescription insertswhich were previously used as a form of refractive surgery in the treatment of low levels of myopia or nearsightedness, but has recently received FDA approval for keratoconus.

Intacs and Corneal Collagen.

Keratoconus Intacs is a single day procedure performed in the OPD section. Eyes are numbed by putting anesthetic drops, and lid holder is applied to the eye to prevent blinking. 

Surgeon creates a thin channel within the cornea to insert Intacs with the help of high-speed Femtosecond Laser beam. Then, one or two Intacs, are inserted as per requirement. 

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Then, one or two Intacs, are inserted as per requirement. Individual shape of the cornea decides the requirement of one or more intacs. 

Surgeons insert intacs into the outermost edge of the cornea keeping the center portion untouched.

As the procedure ends, surgeon places a contact lens bandage, puts drops on the eyes and uses a plastic shield to keep the eye safe. 

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Intacs are made from a contact lens-like material, and the shape is like two small crescents.

Insertion of intacs makes the cornea flat, and it reduces the irregular astigmatism and asymmetries of cornea caused by Keratoconus.

Surgeons have found it useful for cross- linking of corneal collagen and vision improvement as well. The procedure also corrects without glasses or contact lenses.

Post-operative care.

Vision improvement happens immediately after the procedure, but there may be fluctuations initially. Patients can resume work within one or two days with a few restrictions. 

Doctors look at the improvement during the follow-up period and perform additional procedures if required.

It can be changing size and position of intacs, adding supplementary procedures like Conductive Keratoscopy or  CK. 

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Cornea improves in a majority of cases, but there can be a need of contact lenses or spectacles.

 In rare cases, there are secondary problems like insertion of intacs or infection during corneal healing.

Surgeons take the decision of removing intacs in some extreme cases. All these complications are discussed with patients before surgery. 

Intacs and CK- the combined surgery.

Eye specialists are always in search of innovative procedures for treating eye problems. It has been observed that in a few cases, it is possible to combine Conductive Keratoplasty with Intacs procedure.

It can be performed in a single session or back-to-back depending on the situation. It is a revolutionary approach to correct Keratoconus.  

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Since CK is a procedure of correcting the shape of the cornea by shrinking the collagen, it allows excellent reshaping of a keratoconus cornea when combined with Intacs procedure.

It can be done along with Intacs or when the sutures get removed. 

It is not a recognized procedure by FDA and the clinic has to take approval for it.

Intacs And Corneal Collagen Cross-linking

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Since CK is not an approved procedure for correcting Keratoconus (though it is approved for correcting farsightedness), patients have to select it as an offline procedure. 

In a few cases, Intacs may act as a supplementary procedure for correcting severe nearsightedness through LASIK or LASEK/PRK procedures. 

So far, clinical trials have shown quite satisfactory and enthusiastic results.

Corneal Collagen Cross-linking procedure or CXL.

CXL is a relatively new and experimental procedure performed in a few countries of Europe. 

It is still under observation and research is being done to assess its effectiveness and safety in correcting problems like Keratoconus or Corneal Ectasia after LASIK surgery.

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It is a procedure performed with the primary goal of strengthening and stiffening the corneal fibers so that progression of Keratoconus can be prevented.  

It also decreases the cone steepness in some cases. Though the safety and effectiveness are still points of research, initial results show that it is quite effective.

The procedure.

Surgeons put anesthesia drops to prevent pain and discomfort. A lid retainer is installed to prevent blinking. 

The surgical procedure starts with removing of surface epithelial cells of the cornea. 

Riboflavin drops put for 30 minutes so that cross-linking effect gets enhanced and the rest of the eye from exposure to Ultraviolet exposure.

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Patients are told to look at a source of UV light (365 microns of wavelength and 3mW/cm2 power) for half an hour. A soft contact lens bandage is applied. 

Anti-inflammatory drops and antibiotic drugs are prescribed for two weeks. Contact lenses are placed for a week so that the healing process can be improved.

Conclusion.

Intacs procedure is one of the prominent and important procedures for correcting Keratoconus. 

It is equally effective in making the eyes tolerant of contact lenses. It avoids the possibility of corneal transplant up to a large extent. 

 It avoids the possibility of corneal transplant up to a large extent.

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Improving vision correction with glasses or contact lenses is other applications. 

Some patients achieve a fantastic correction while some need additional corrections. 

Many specialty hospitals and eye treatment centers offer it, but it is very important to check the proficiency and expertise of the doctors.

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