Intacs

What is Keratoconus?

Keratoconus is a progressive eye disorder that causes the cornea to become conical in shape and produces a number of visual problems including myopia (nearsightedness), astigmatism, streaking, multiple ghost images and sensitivity to light. In most cases, contact lenses or glasses can correct most visual acuity problems associated with keratoconus. In some cases, however, contact lenses and glasses are insufficient treatment. Some patients cannot tolerate contact lenses and some may not get enough vision correction from either contact lenses or glasses.

Eyes after intacts

Eyes after a corneal transplant

Intacts

What Are Intacs?

Intacs are a newer keratoconus treatment option, which is performed by Dr. Ilan Cohen of Fifth Avenue Eye Center. Intacs for keratoconus has demonstrated excellent results. Intacs are corneal ring segment inserts that are also used as an alternative to laser surgery to correct refractive errors not related to keratoconus. These thin, semi-circle implants are made from Plexiglas. They are inserted into the outer edge of the cornea to create a flatter cornea shape. Flattening corneal steepness can improve vision and make the eyes more tolerant to contact lenses.

About the Procedure:

The Intacs procedure is done on an outpatient basis by Dr. Ilan Cohen and only takes about 15 minutes per eye. Before the procedure, the eye is numbed with anesthetic eye drops. Channels for the inserts are created in the outer edge of the cornea using either a laser or a mechanical spreader. The laser creates fewer complications related to depth of placement and produces better overall results. The Intacs implants are then inserted into the channels to reshape the cornea and opening is closed.

What to Expect Afterwards:

The results of the Intacs procedure are immediate. Some minor improvement of visual acuity even without contact lenses can be expected, but the main improvement is seen in contact lens tolerance. Patients who could not wear contact lenses because of keratoconus can return to wearing contact lenses soon after. It’s important to note that this procedure is not intended to completely correct visual acuity in patients with more than mild keratoconus. Some myopia and astigmatism will likely remain even after the Intacs procedure and some visual correction will probably still be required.

Benefits of Intacs for Keratoconus:The Intacs procedure is often used to prevent the need for corneal transplant in the future. Until Intacs became a commonly accepted keratoconus treatment, corneal transplants were the only treatment option for those who could not tolerate contact lenses. Corneal transplants remove the corneal tissue and replace it with grafted donor tissue. This procedure requires a lengthy recovery (4 to 6 weeks), and it can take up to a year for the vision to stabilize after the surgery. The Intacs procedure is far less invasive and has much less chance of complications than corneal transplant. The main complication, though rare, from Intacs is infection, which can occur with any surgery and can be virtually prevented with prophylactic antibiotics. Intacs are also a better option than corneal transplants because they do not alter the tissue of the eye and can be easily removed (complete reversal) if necessary.

Dr. Ilan Cohen at Fifth Avenue Eye Center can determine if you are a good candidate for Intacs for keratoconus during an eye screening exam. Generally, the best candidates have stable vision, meaning their keratoconus is not longer progressing.