Intra-Corneal Ring Segments - Laser Eye Surgery Guide

Intra-Corneal Ring Segments, also referred to as INTACS, is a style of eye surgery, which incorporates the positioning of plastic rings on the cornea. This is done to influence the cornea's shape so vision is improved. These implants are a rather innovative addition to the already broad market of refractive surgery.

The rings are clear and composed of acrylic. The rings are carefully inserted into the cornea but in a reversible fashion and so can be removed at a later date if necessary. The medical names for the plastic rings are intra-corneal ring segments or intrasomal corneal rings (ICR) and the flattening effect that they impart onto the cornea is effective in reducing short-sightedness (myopia).

How does this form of eye surgery vary from other laser eye procedures?

The most significant difference that separates ICR from other treatments such as LASIK is that corneal tissue is not removed. Instead, a diamond blade is employed to precisely create a small cut in the cornea, which acts as an entry point for the acrylic rings. The resting place of each of these rings is in between the layers of the cornea.

Some clinics, however, do actually use a laser rather than a blade to performed this procedure. This process is very technologically advanced and involves the use of an Intralase femtosecond laser. This type of laser can also be seen in other laser eye surgeries such as Wavefront LASIK. It is worth checking with your clinic prior to surgery to discover which method is used.

Am I a suitable candidate for ICR?

Those who suffer from myopia or short-sightedness in a mild way then ICR may be ideal for you. This type of surgery may also be recommended to you if you have be designated as unsuitable for other procedures such as LASEK and PRK. This refusal may be the result of you having thin corneas, which is not so much of an issue in ICR as no corneal tissue is removed.

A consultation with a surgeon is vital to determine whether or not you will be suited to the ICR procedure. To determine your suitability, your surgeon will analyse areas of your life including your age, general state of health, eye health, lifestyle and the reasons behind you wanting the surgery. It is also necessary that you have realistic expectations in regards to the results of the ICR surgery.

If you are over the age of 21 and have a stable eye prescription, which has not changed over the past 2 years, then this is a good starting point if you are seeking treatment by ICR. It is also important that you do not have any underlying medical conditions that may affect the outcome of the procedure.

If you are currently pregnant or breastfeeding then you will probably be advised against undergoing ICR. Other factors that may designate you as an unsuitable candidate are if you have or have had certain eye disease or if you suffer from an autoimmune disease.

Potential risks of ICR

ICR in general is a very safe procedure and risks or complications are rare. However, they are possible and occur in the minority of patients and so are very much worth considering. The most common risks and complications that are experiences due to ICR include:

  • Glare, halos or starbursts
  • Under- or over-correction
  • Eye infections
  • Surgery induced astigmatism
  • Inhibited night vision
  • Your vision may become double or blurry
  • The quality of your distance vision may vary

All these risks, and any others that may be relevant to you, should be discussed with you during your consultation. If not then ask your surgeon specifically.

Benefits associated with ICR

There are a number of benefits that can results from undergoing the ICR procedure. Primarily, short-sightedness (myopia) can improve significantly and you vision may become generally much clearer and sharper.

Other aspects considered beneficial include the very quick recovery period as a result of no tissue being removed from they eye.

A benefit that is solely unique to ICR is that the acrylic rings can be replaced in case your eyesight changes. These rings are also comfortable and you should not be able to feel them at all so there is no change or inconvenience to your everyday life.

Your ICR consultation

Before undergoing ICR surgery you will attend a consultation with the surgeon who will carry out your procedure. During this consultation you should ask all the questions that you can think of about your procedure and the recovery time as well as about the surgeon's experience, skills and qualifications. For some tips on what sort of questions may be valuable to ask your surgeon, please visit our section called, 'Laser Eye Surgery: General FAQs'.

To conclude your consultation, your surgeon should supply you with an accurate quote as to how much your ICR procedure will cost and the payment options available. The prices of the procedure will vary between surgeons and clinic due to skill, technology, location, aftercare and other aspects. Therefore, it may be worth having a number of consultations and comparing the costs. But as a rough estimate, you can expect to pay approximately £2000 per eye.

The ICR procedure

To begin the procedure, your surgeon will attach a special clip to hold your eyelids apart and prevent you from subconsciously blinking through the surgery. When this clip is in place, some local anaesthetic will be administered in the form of eye drops. These drops will numb the eyes so that you do not experience any unnecessary pain or discomfort throughout the ICR procedure.

The next step involves your surgeon creating a very small incision in your cornea to generate two tiny channels. These channels are the locations into which the acrylic rings will be inserted. The rings can then be adjusted and rotated to ensure that they are in the correct position to flatten out the cornea.

In total, your ICR procedure should not take longer than 15 minutes per eye.

How long can I expect the ICR results to last?

Thanks to the acrylic rings being replaceable, the outcomes of ICR are long-term and can be adjusted to complement your eyesight throughout life. Once in position, the rings can be left for as long as you wish them to be. If you feel like the treatment is not having the desired beneficial results then you can easily get the rings removed and try another method.

The recovery period after your ICR procedure

Some patients comment that their eyes feel itchy for the first few hours after the ICR procedure. Sometimes, they also experience the feeling of something being in their eye. To help deal and ease this discomfort, you can apply prescribed eye drops.

The time needed for recovery is short and you should be able to return to your normal life within the week after your surgery. In these days, you should also be able to notice the difference in your vision. Despite this, it can take as much as three months for healing to be completely done and for your eye to normalise.