Khanna Vision Institute Keratoconus

Intralase Channels and Intacs insertion

Intralase laser is a high energy small burst laser which can create a channel in the cornea. The surgeon has the control to set the dimensions for this channel. This is a circular path created by the intralase using special properitery software from Abbot Medical.The depth of the channel is ofcourse the most important factor and can be set by the Intacs surgeon. Usually with the intralase method the intacs can be placed deeper at 90 % depth of the cornea. 50 to 100 microns are left intact below the Intacs. This yield the best chance for the Intacs ring segments to work to treat keratoconus and least chance for extrusion from the surface.

The corneal surgeon will also need to set the inner and external diameter for the channel. These dimensions vary based on the thickness of the intacs ring segments, that is 210 or 350 or 450 microns. Again, the commonly used numbers are 6.8 mm for internal and 7.6 mm for external diameter.Finally, keratoconus surgeon needs an entry into this channel. The software allows the doctor to set the location for this vertical incision. The keratoconus expert with experience in Intacs insertion would usually set this at 90 degrees from where he wants the center of the Intacs to be finally placed.

Right eye with Intac ................Left eye with Intac

These pictures are taken with an i phone on day 2 after intacs insertion with channels created by intralse laser. The intacs are clearly seen. They are 450 microns, centered infertemporally, to support the cone of keratoconus.