Surgeons have tried many techniques to address refractive errors by altering the cornea and there will likely be many more in the future. Today, we primarily perform laser based corneal refractive surgery (LASIK, PRK, SMILE) and surgeons have largely abandoned other forms such as radial keratotomy and conductive keratoplasty. This video shows the use of intacs which are intra-corneal ring segments that were designed to address low levels of myopia by causing central corneal flattening. Today surgeons don’t often use intacts for this reason, but they are still used as bolsters to help support a weak cornea such in some cases of keratoconus. This video gives some important pearls about how to perform cataract surgery in these eyes, how to do the IOL calculations, and how to determine if these intacs should be left in place or removed.