Intacs are brand-name medical devices that are surgically placed into your eyes to reshape your cornea and treat keratoconus. (Learn More)

Keratoconus is a condition that causes your cornea to thin out and become irregularly shaped (like a cone). The condition is both progressive and degenerative.

Vision distortion from keratoconus can be treated with contact lenses and glasses to a point. As the condition progresses, more intensive treatment is needed.

Intacs can actually help to stall the progression of the disorder and reshape your cornea. (Learn More) Intacs can potentially defer your need for a corneal transplant, but Intacs still involve a surgery that carries some risk. (Learn More)

The placement of Intacs is a quick surgical procedure done in an outpatient surgical center or an ophthalmologist's office. It comes with a fast recovery time. (Learn More)

Intacs Corneal Implants

Intacs were initially designed to be used for refractive eye surgery to correct for myopia (nearsightedness). They are medical ophthalmic devices that are surgically placed into your eyes. In 2004, the FDA approved the use of Intacs for the treatment of keratoconus.

Intacs are a brand-name product. They consist of a thin clear plastic ring that is surgically placed into the middle of your cornea.

With keratoconus, your cornea develops a cone shape as it thins out and bulges outward. This can distort your vision due to changing the way light is reflected back onto the retina. Intacs can help to flatten the cone and therefore improve your vision.

Keratoconus is a progressive disorder. It usually starts in a person’s late teens. Over the next 10 to 20 years, it can continually progress until vision is significantly impaired. Eventually, it can result in the need for a corneal transplant.

Intacs is a much less invasive surgical procedure that can potentially slow the progression of keratoconus. Placement of Intacs can at least delay your need for a corneal transplant.

 

Intacs & Other Keratoconus Treatments

There are varying degrees of keratoconus, and different treatment needs for the various stages.

With mild keratoconus, in the early stages, blurry vision, sensitivity to light, and some vision distortion are common. As the cornea thins and continues to bulge through the progression of the disorder, vision becomes more and more impaired.

Treatment options for keratoconus typically progress like this:

Orthokeratology contact lenses

  • Eyeglasses or soft contacts
  • Rigid gas permeable contacts (or potentially hybrid or "piggybacking contacts")
  • Intacs
  • Collagen cross-linking
  • Corneal transplant

At first, eyeglasses or standard soft contact lenses are often enough to correct for the vision issues related to keratoconus. As the disorder progresses, however, specialized contacts are often needed.

Keratoconus can deteriorate the cornea to the point where contacts are not comfortable to wear anymore. Prescription contacts and eyeglasses also do not slow the progression of keratoconus. Deterioration of the cornea is not reversible.

Intacs can help to reshape the cornea, flatten the cone, and minimize the risk for disease progression and the need for a corneal transplant.

Collagen cross-linking is another procedure an ophthalmologist can perform to strengthen the cornea. This can stabilize it and keep keratoconus from progressing further. Corneal cross-linking does not reshape the cornea; instead, it serves to stabilize it.

These two procedures (Intacs and corneal cross-linking) can complement each other. The cross-linking can stabilize the cornea, while Intacs reshape it.

A corneal transplant is the most extreme treatment for keratoconus. It can be necessary when the disorder has progressed to an advanced stage, and vision is severely impaired. A corneal transplant is a surgical procedure that replaces the diseased cornea with a healthy donor cornea.

Pros & Cons of Intacs

As opposed to contact lenses and prescription eyeglasses, Intacs can reshape your cornea to restore vision loss attributed to keratoconus. Progression of the disorder can also be slowed.

The Intacs procedure is reversible, and the inserts can be removed if necessary.

The procedure to place Intacs is minimally invasive, and recovery is usually fairly quick. The placement of Intacs can also make it so that you can comfortably wear contacts again.

Just as with any surgery, there is a risk of complications with Intacs, such as infection. You may also experience glares or halos around lights, as well as some difficulties with night vision.

Intacs can improve your vision, but blurriness and vision distortion are possible after the procedure. This can mean that you will need to continue to wear prescription glasses or contacts.

Surgeons performing an eye surgery under the microscope at the hospital - healthcare and medicine concepts

What to Expect With Intacs

Keratoconus can be diagnosed through regular eye exams that measure the shape of your cornea as well as any vision issues. By detailing changes with routine eye exams, an eye doctor can recognize keratoconus in the early stages. Early diagnosis allows your doctor to provide you with the best treatment options.

Keratoconus usually progresses very slowly over a period of years, but it can differ in its progression from eye to eye.

The first line of treatment is generally prescription eyewear. Once that is no longer successful and the condition is more advanced, procedures such as Intacs may be recommended.

  • Prior to surgery: Before Intacs are placed into your eyes, your eye doctor will perform a full eye exam and measure the size and shape of your corneas. They will discuss the treatment, procedure, and recovery information with you in depth.
  • During the Intacs surgical procedure: During the actual procedure, topical anesthesia is used to numb your eyes. You will have the surgery done in an ophthalmologist's office or an outpatient surgery center. It typically only takes about 15 to 20 minutes to complete the full procedure.

    The surgeon will make a small incision, usually with a laser, in the surface of the cornea. To stabilize the eye, a centering guide is placed on the eye, and the corneal layers are separated.

    The Intacs are placed on the outer edge of your cornea to smooth and flatten it. You can feel pressure and a small tugging sensation as the outer suture is placed.

  • Recovery: You will need someone to drive you home from the office after the procedure. You should not drive or lift heavy objects for a day or two.

    Your doctor will go over the exact recovery procedures with you and schedule follow-up appointments. It can feel like you have something foreign in your eye for a few days, but this sensation and your vision will clear in just a few days.

Depending on the level of correction needed, you may still need to wear contacts or glasses to see clearly. The American Academy of Ophthalmology (AAO) reports that minor stinging and some tearing are common right after the placement of Intacs. The relatively minor discomfort should be manageable with over-the-counter painkillers.

Intacs are a safe and minimally invasive treatment for keratoconus that can help to slow the progression of the disorder. The treatment can improve your vision and defer the need for a more invasive corneal transplant and severe vision deterioration.

 

References

About Intacs. (2015). Addition Technology, Inc.

Intacs Surgery for Keratoconus. National Keratoconus Foundation (NKF).

Keratoconus. (January 2020). U.S. National Library of Medicine (NLM).

Examining the Cross-Linking/Intacs Link. (November 2012). Review of Ophthalmology.

How Painful Is Recovery From Intacs Surgery? (October 2015). American Academy of Ophthalmology (AAO).