Intacs (Corneal Implants for Keratoconus): A Complete Guide

Introduction to Keratoconus and Its Impact on Vision

Keratoconus is a progressive eye disorder where the normally round cornea thins and bulges into a cone-like shape, leading to distorted vision. This condition typically begins in the teenage years and worsens over time, causing blurred vision, increased light sensitivity, and difficulty with night vision. Many patients experience frequent changes in eyeglass prescriptions, yet standard lenses often fail to provide clear vision.

Living with keratoconus can be challenging. Simple tasks like driving, reading, or recognizing faces become difficult. Without proper treatment, advanced cases may require corneal transplants. Fortunately, treatments like Intacs (corneal implants) offer a minimally invasive solution to stabilize the cornea and improve vision.

What Are Intacs? (Overview of Corneal Implants)

Intacs are small, crescent-shaped plastic inserts surgically placed within the cornea to flatten its shape and correct the irregular curvature caused by keratoconus. Unlike laser eye surgery, Intacs do not remove corneal tissue. Instead, they act as supportive scaffolding, redistributing pressure and improving vision clarity.

Approved by the FDA in 1999, Intacs are a reversible and adjustable treatment. They are particularly beneficial for patients with mild to moderate keratoconus who struggle with contact lens intolerance. The procedure is quick (about 15 minutes per eye) and can delay or even prevent the need for a corneal transplant.

How Do Intacs Work for Keratoconus?

Intacs work by reshaping the cornea to reduce irregularities caused by keratoconus. When implanted in the outer edges of the cornea, they flatten the cone-like bulge, allowing light to focus more accurately on the retina. This reduces distortions like halos, glare, and blurriness.

The implants are placed in a deep corneal layer (stroma) through a small incision, preserving the central cornea. Since they’re placed peripherally, they don’t interfere with future treatments like cross-linking or transplants. Many patients notice improved vision within weeks, though full stabilization may take a few months.

Who Is a Good Candidate for Intacs?

Ideal candidates for Intacs have:

Patients with severe keratoconus, corneal scarring, or very thin corneas may not qualify. A thorough evaluation by an ophthalmologist, including corneal topography, determines eligibility.

The Intacs Surgery Procedure: Step-by-Step

Intacs surgery is an outpatient procedure performed under local anesthesia. Here’s what to expect:

  1. Preparation: Numbing eye drops are applied. The eye is cleaned and held open with a speculum.
  2. Incision: A small incision is made in the cornea, and a laser or mechanical device creates tunnels for the implants.
  3. Insertion: The Intacs segments are placed into the tunnels using specialized instruments.
  4. Closing: The incision is self-sealing; stitches are rarely needed.

The entire process takes about 15–30 minutes per eye. Patients can return home the same day but will need someone to drive them.

Recovery and Post-Operative Care After Intacs

Recovery after Intacs is relatively quick, but proper care ensures optimal results:

Most patients resume normal activities within a few days, but vision stabilizes over 3–6 months.

Benefits and Potential Risks of Intacs

Benefits:

Risks: Though rare, complications include infection, glare/halos at night, or under/over-correction. Proper surgeon selection minimizes risks.

Intacs vs. Other Keratoconus Treatment Options

1. Corneal Cross-Linking (CXL): Strengthens the cornea but doesn’t improve vision alone. Often combined with Intacs.

2. Rigid Contact Lenses: Provide clear vision but can be uncomfortable. Intacs may reduce lens dependence.

3. Corneal Transplant: Reserved for severe cases. Intacs offer a less invasive alternative.

Intacs are unique because they both stabilize the cornea and improve vision, making them a versatile option.

Frequently Asked Questions (FAQs) About Intacs

Are Intacs permanent?

No, they can be removed or adjusted if needed, but many patients keep them long-term.

Does insurance cover Intacs?

Some plans do if keratoconus significantly impacts vision. Check with your provider.

Can Intacs be combined with other treatments?

Yes, they’re often paired with cross-linking for better stability.