UK Keratoconus Self-Help and Support Association

Hi

I had CXL done in both eyes just over a year ago but I now need to have Intacs in the right eye. I've looked through this forum and seen quite a few stories from people who have had some bad experiences with them - from eyes pushing the Intacs back out, to them coming loose shortly after insertion, to people suffering from glare and bright light badly afterwards.

I'm a bit nervous about having it done. When I had the CXL done I found it very painful but have been told by the surgeon that the Intacs procedure won't be as bad. However, some of the posts on here so far have been less than reassuring.

I'm not expecting a miracle cure for the vision, as so far nothing seems to be making it any easier for Lynn (White) to get contacts to work. It's one thing after another and what should be a simple case continually frustrates Lynn's efforts. However, I would like some positive news on Intacs.

Does anyone have any good news about them? Any positive news on how pain free they've been and how little trouble the procedure was? Anything to reassure me?

In hope
Dan

Having re-read my own post, I should clarify - the fact that nothing is working is down to my eyes and other issues, not the skill or effort of Lynn who has persisted brilliantly and who is often as frustrated as I am.

Hi Dan,
The problem is that satisfied customers often don't bother to post - only the ones who have problems! We've certainly had members who have reported that Intacs have worked for them - 2 of them spoke at our 2007 conference. I don't have any personal experience of Intacs, but I hope someone who has had a positive experience will see this post.
Anne

Hello

In my opinion in order to be successful with Intacs it is very important to choose the right candidates. No everyone with keratoconus is a good candidate for this technique. This could be obvious in some countries but in some areas ICR procedures are very heavily recommended.

For instance in some publications it has been reported that ICR implantation could be positive to fit RGP in very steep corneas but our experience is not that. Also in some countries it is said ICR could hasten the progression of the disease but this claim has not been proofed.

Also it is important to correctly manage patient’s expectations. In clinical practice we could see "miracles" and "horror cases" but neither of the two scenarios are the norm.

In this way with my patients I always discuss the following figures about results:
- 85% of cases will improve uncorrected visual acuity
- Almost 70% of cases will improve spectacle corrected visual acuity
This figures allow me to discuss the possible risk for NO improvement after the surgery

But how much? It depends. But there are studies that show that more or less as you see with your glasses on (no with contacts) before the procedure is how you would see after a successful ICR surgery but now without glasses. If your vision with glasses is very poor, probably the prognosis for good vision after the procedure is not very obvious. In terms of dioptres we work with the concept of spherical equivalent (sphere dioptres + astigmatism dioptres/2) and the possible reduction after the surgery as about 4 dioptres. In those cases with very severe myopia, the possible dioptre reduction could be possible but the patient do not feel it.

regards