Intacs are placed in the outer layers of the cornea, which helps to correct abnormalities in the curvature of the cornea. Correcting the shape of the cornea may allow patients to wear contact lenses when they could not previously and may also prevent the need for any other corneal surgeries.
Corneal intacs are small intracorneal ring segments (also known as ICRS) that are implanted into the eye. Intacs were originally FDA-approved, in some situations, to correct low degrees of nearsightedness. In 2004, intacs were approved by the FDA for the treatment of keratoconus and other corneal eye conditions. Results of intacs for keratoconus treatment have been encouraging, especially in patients unable to tolerate contact lenses or in need of a corneal transplant.
Intacs are two small crescents of a contact lens-like material (PMMA). Unlike procedures such as LASIK, intacs are implanted into the outer edge of the cornea so that the center of the cornea remains untouched. The insertion of intacs causes the cornea to generally flatten. In addition, intacs tend to decrease the irregular astigmatism found in keratoconus. They can be safely removed if necessary. In such cases, the cornea will generally return to its preoperative condition.
The implants are placed in the cornea outside of the patient’s line of sight to flatten the cornea and essentially reduce the cone or bulging that has developed. Intacs implants are designed to be placed in the periphery of the cornea at two-thirds depth and are surgically inserted through a small incision in the corneal stroma.
The primary goal of Intacs in keratoconus is to make the eye again tolerant of contact lenses and to avoid corneal transplantation. Other goals are to improve vision with glasses as well as uncorrected vision (without glasses or contact lenses). The goal of Intacs varies with the severity of your problem.
With any type of surgical procedure, patients experience anxiety, but it may be comforting for the patient to know that the Intacs procedure is less invasive than a corneal transplant and other ocular surgical procedures. Intacs has a high success rate and is typically performed in about 15 minutes per eye.
At the beginning of the procedure, topical numbing drops are applied. A lid holder supports your lids to avoid blinking during the procedure. A channel within the cornea is then prepared, into which the Intacs will be inserted. This step is done with a Femotsecond laser or with a special intracorneal tunneling instrument. We generally prefer the Femtosecond laser technique, finding a more robust result in patients treated in this way. However, the ultimate selection of technique depends on your particular situation.
In either case, a suction ring is placed to stabilize the eye and the channel is then prepared for the Intacs to be inserted. Some patients may have two Intacs placed, others may have only one placed depending on the individual cornea. At the end of the procedure, a stitch or contact lens bandage is placed, eye drops are given, and a clear plastic shield is applied for protection. You will use eye drops to avoid infection and inflammation for one week.
The Intacs procedure works on the concept of reshaping the cornea from within utilizing implants that provide support to a weakened cornea. The recovery period is typically short compared to a patient who undergoes a corneal transplant, and patients notice vision improvement rather quickly. Vision begins to improve the day after the procedure but may fluctuate for several days. Most people can return to work one to two days after the procedure. During your follow-up examinations, we will determine if additional procedures may be beneficial. These include changing Intacs size or position, adding supplemental procedures such as conductive keratoplasty (CK) and other techniques. Keep in mind that Intacs is not necessarily a one-time procedure. Further treatment might be necessary over the months after your surgery to enhance and optimize the final result.
If you believe intacs may be the right choice for you, speak with one of our eye care specialists today. Make an appointment at one of our seven convenient locations.
Or call 678-381-2020