Intacs-for-Keratoconus

INTACS is the trademark name for micro-thin prescription inserts which were previously used as a form of refractive surgery in the treatment of low levels of myopia or nearsightedness, but have recently received FDA approval for keratoconus. Narayana Nethralaya was the first hospital to introduce INTACS in the country in 2005.

INTACS are thin plastic, semi-circular rings inserted into the middle layers of the cornea. When inserted in the keratoconus cornea they flatten the cornea, changing the shape and location of the cone. The placement of INTACS remodels and reinforces the cornea, eliminating some or all of the irregularities caused by keratoconus in order to provide improved vision. Though INTACS can often improve uncorrected vision, however, depending on the severity of the keratoconus, glasses or contact lenses may still be needed for achieving the best possible functional vision.

FDA Approval
Intacs were approved under a Humanitarian Device Exemption (HDE) by the FDA in July 2004, allowing INTACS to be used for treating keratoconus. As part of the HDE approval, Addition Technology, the manufacturer of INTACS has implemented an extensive training program in which each surgeon will be required to participate.

FAQ’s about INTACS

How do Intacs work and how might they help me?
Intacs-for-Keratoconus1Due to the onset and progression of keratoconus, the weakened cornea looses its natural dome-like shape. As a result, the light rays entering the eye are no longer focused properly, impairing one’s ability to see images clearly.
INTACS are specially designed inserts, made of medical plastic, which are surgically placed under the surface of the cornea. Due to their unique patented design, INTACS are able to remodel the architecture of the cornea re-establishing a more natural dome-like shape and improving one’s vision.

What are the advantages of the Intacs procedure as compared to a corneal transplant?
A corneal transplant is an invasive surgical procedure, requiring the removal of a section of your cornea and having it replaced with donor tissue. Although successful, it is a delicate procedure with typically a long recovery period.

The INTACS procedure does not require removal of corneal tissue, but rather works on the principle of reshaping your own cornea from within utilizing special designed corneal inserts that provide structure to a weakened cornea. The recovery period is typically short, with visual improvement noticed almost immediately. If after INTACS visual improvement is not adequate, then a corneal transplant can still be performed if needed. In the few cases in which a corneal transplant was performed after an INTACS procedure, there were no complications reported.

What is the procedure for INTACS?

  • The INTACS procedure is far less invasive than a corneal transplant or many other surgical procedures of the eye and the INTACS success rate is high. The surgeons performing the procedure are typically corneal surgeons, having expertise with keratoconus. Each surgeon has also undergone a rigorous training program specific to INTACS for treating patients with keratoconus.
    Typically, your ophthalmologist, possibly working in tandem with an optometrist will have you undergo a thorough eye examination.
    Your examination will include a variety of standard ophthalmic tests for this type of procedure, as well as general medical tests and a review of your specific medical history.
    The operative procedure itself is simple.
  • Anesthetic drops are used to numb the eye, which is held open throughout the procedure to prevent blinking. The surgery does not require any injections.
    Step 1: A single, small incision is made in the surface of the cornea.
    Step 2: To stabilize your eye and ensure proper alignment of the INTACS inserts, the centering guide is placed on the surface of your eye. During this time, inner layers of the cornea are gently separated by laser in a narrow circular area to allow for INTACS placement.
    Step 3: The INTACS inserts are gently placed in the pocket created by the laser.
    After the second INTACS insert is placed, the small opening in the cornea is closed with a single suture.
  • Follow-up visits will be required to monitor the healing process and evaluate the visual benefits of the procedure. Even after a successful procedure, glasses or contacts still may be required to provide you with good vision.
  • During the follow up period antibiotic, steroid and artificial tear drops will be prescribed.
  • Suture is removed after one month.
  • Contact Lens/ Glasses are given after 6 weeks.

What are the precautions I need to take after the INTACS surgery?

  • It is advisable to take rest for 1-2 days after surgery.
  • Avoid cosmetics around the eyes for one month.
  • Avoid contact sports/swimming/lifting weights for 3 weeks.
  • Contact your doctor if you develop pain /redness/discharge.

As with any surgical procedure, there are some risks, including infection. Some patients experience visual symptoms including difficulty with night vision, glare, halos, blurry and fluctuating vision.

THESE SYMPTOMS MAY BE TRANSIENT AND RESOLVE 3-6 MONTHS AFTER SURGERY.YOU HAVE TO UNDERSTAND THAT INTACS IS DONE NOT TO ELIMINATE THE USE OF GLASSES /LENS BUT TO STABILIZE THE CORNEA AND THIS IN TURN MAY REDUCE SOME REFRACTIVE POWER OR MAKE THE WEARING OF CONTACT LENSES/GLASSES MORE COMFORTABLE FOR YOU.