Intacs corneal inserts or implants are a minimally invasive surgical option used primarily for the treatment of keratoconus.
What Are Intacs Corneal Implants Used For?
Initially FDA-approved in 1999 for the surgical treatment of moderate myopia (-1.0 to -3.0 diopters), Intacs are two tiny, clear crescent-shaped pieces of a plastic polymer that are inserted into the cornea to improve the front surface area of the eye.
The FDA in July 2004 given Intacs a Humanitarian Device Exemption for use in the treatment of keratoconus largely since of Intacs’ safety record and since just a couple of treatment choices, such as corneal transplants, were offered for keratoconus.
The approval allows Intacs to be marketed for decrease or elimination of myopia and astigmatism in keratoconus patients where practical vision is not gotten with contact lenses or glasses.
In early January 2006, the FDA formally acknowledged that Intacs implants are restorative devices that can be described in company literature as corneal implants, rather than prescription inserts.
The corneal implants are developed for long-term vision correction. If you are amongst the 4 percent of people who are not pleased with outcomes or you have unpleasant visual symptoms, you can ask a surgeon to get rid of the Intacs.
Intacs can be changed with different-size implants or gotten rid of for good. You have the option of changing them with brand-new rings at a later date if your prescription modifications with age.
If Intacs are removed, vision has the tendency to return to the method it was prior to surgery within 3 months. Those getting replacement Intacs have actually acquired good visual outcomes also, and no serious issues with duplicating the procedure have been reported.
How Do Intacs Work?
For treating nearsightedness, Intacs appropriate vision by flattening the cornea to refocus light rays and enhance vision. For keratoconus, Intacs work by flattening the steep part of the cornea or cone to minimize vision distortions.
Intacs are made of the very same biocompatible material found in intraocular lenses used for cataract surgery, so there is little or no risk of negative results from the product.
In a few cases, however, eye irritation, blepharitis or unusual blood vessel development in the cornea (neovascularization) may take place. Also, Intacs might produce no restorative effect in fewer than 5 percent of individuals with keratoconus.
The procedure takes about 15 minutes and is done on an outpatient basis, but you will require somebody to drive you home after surgery. Prior to surgery, your doctor locations anesthetizing drops in your eye and might give you a mild oral sedative.
During the procedure, your surgeon produces a tunnel in between layers of the corneal stroma, beyond the central optical zone.
The surgeon then chooses the proper ring thickness. A thicker ring in Intacs suggests more flattening of the cornea, which increases the level of vision correction accomplished. After one or two crescent-shaped Intacs are inserted into the tunnel, the procedure is over.
Best Candidates for Intacs Corneal Inserts
- keratoconus, poor vision with glasses or contact lenses
- Procedure time: about 15 minutes per eye
- Normal results: crisper, clearer vision without glasses or contact lenses
- Recovery time: a few days to numerous months
- Cost: about $1,500 to $2,500 per eye
After Intacs Surgery
You’ll probably rest for a while, then go home (have somebody else own you). Many people have sharper vision the first day after surgery, but you might require a couple of days of relaxation to promote recovery. You will not feel the ring sectors, since they are beneath the cornea’s nerve endings. Other individuals cannot see them unless they look really carefully into your eyes.
Results of these implants will depend on the degree of keratoconus in each person. People with milder cases of keratoconus may not need any lenses for extra vision correction. People with moderate keratoconus might require glasses or soft contact lenses for enhanced vision.
For advanced cases, rigid gas permeable contact lenses may be needed to improve vision or to postpone or prevent the requirement for a corneal transplant.
Intacs can be very reliable at changing the shape of the cornea and flattening the cone brought on by keratoconus. But the Intacs procedure can not halt the development of keratoconus brought on by weakening of the collagen (structural protein) within the corneal tissue.
A procedure called corneal cross-linking (CXL) uses a mix of a topical solution of vitamin B (riboflavin) and regulated UV light exposure to strengthen corneal collagen fibers and support the cornea. In many cases, CXL is used in mix with Intacs implants for the best treatment outcome in progressive keratoconus.
Results Of Clinical Trials For Intacs For Keratoconus
Clinical trials of Intacs for keratoconus and other corneal thinning disorders have actually revealed encouraging outcomes.
In a research study of 58 eyes of 43 patients with keratoconus, average uncorrected visual acuity enhanced from worse than 20/200 to much better than 20/60 after Intacs implantation, and the typical quantity of corneal astigmatism decreased from 3.34 D to 1.97 D.
A research study of Intacs for the treatment of corneal thinning and bulging (ectasia) taking place as a problem of LASIK surgery revealed that uncorrected visual skill improved from 20/100 or even worse prior to Intacs implantation to 20/40 or much better one year after the procedure in 90 percent of treated eyes.
And a research study of the effectiveness of Intacs for the treatment of keratoconus and post-LASIK corneal ectasia showed that insertion of a single Intacs sector in these eyes enhanced uncorrected visual skill to the extent that the individuals in the study might see 9 lines better on a basic eye chart.
Intacs For Nearsightedness
Regarding using Intacs for the correction of myopia, a literature evaluation of 452 people who went through the procedure discovered that 12 months after surgery, 97 percent of dealt with eyes had 20/40 vision or much better, and 74 percent had 20/20 or much better.
Just under 9 percent of patients requested to have their Intacs removed due to side effects such as glare, halos and night vision problems or because their vision was under- or over-corrected, and 3.8 percent required a secondary surgery. There were no severe complications.
Among the advantages of the Intacs procedure is that the corneal ring sections can be gotten rid of if essential. In other words, the procedure is reversible if outcomes aren’t best.
A study of the reversibility of Intacs for nearsightedness, found that, at three months following elimination of the Intacs corneal ring sections, 20 of 21 eyes returned to within 1.0 D of their preoperative refractive error and there were no surgical or postoperative complications.
Are You A Candidate For Intacs?
If you are considering Intacs surgery for keratoconus, your initial step is to have a thorough eye test by an ophthalmologist who focuses on the procedure. He or she will analyze your eyes and carry out a variety of measurements to figure out if the procedure is most likely to enhance your vision.
If you are interested in Intacs corneal ring implantation for the correction of nearsightedness, you need to be at least 21 years of age and have a steady glasses prescription without any more than -3.0 diopters (D) of myopia and no more than 1.0 D of astigmatism.
After examining your eyes, your optometrist can tell you more about Intacs. The cost of the procedure differs from surgeon to surgeon, but usually Intacs cost slightly more than laser vision correction.
