What are Intacs?
Intacs are thin, clear, semi-circular plastic ring inserts that can help provide clearer vision for those with vision problems from a condition known as Keratoconus. These inserts provide a unique alternative to contact lenses and can sometimes postpone the need for a corneal transplant. During the procedure, the inserts are placed in the outer areas of the cornea. The inserts change the curvature of the cornea, reducing the cone-like distortion caused by keratoconus. The procedure allows the cornea to be reshaped without removing any tissue. Intacs are designed to be permanent, but they can be exchanged or even removed if vision needs change over time. Intacs cannot be felt, are no more visible than a contact lens and require no maintenance.
Intacs Procedure – What to Expect
It is important that you are informed of what to expect before, during and after the procedure.
Before the Procedure
You will need to have a preoperative eye examination to determine if your eye is healthy and is suitable for this procedure. Your examination will include a variety of standard ophthalmic tests, general medical tests and a review of your medical history. If you wear contact lenses, it is very important to stop wearing them 2–3 weeks before your preoperative examination per your doctor’s instructions. Failure to do this may produce poor results.
Your doctor will advise you on whether you will be allowed to eat or drink prior to the procedure. You should arrange for transportation after the procedure and to your next examination, since you should not drive immediately after the procedure. Your doctor will advise you when it is safe to resume driving.
The Day of the Procedure
Your physician will briefly discuss the details of the INTACS procedure and what to expect during your procedure. Your presurgical preparation will vary depending on the type of anesthesia your doctor chooses. You will be positioned comfortably, facing up, on a surgical table or reclining chair. Your face will be covered with a surgical drape exposing only the surgery eye. The surgeon will place an instrument between your eyelids to hold your eye open during the procedure. Anesthetic (numbing) drops may be placed in the procedure eye. The procedure will be performed using an operating microscope. A special surgical knife will be used to make a single small incision. A device will be placed on your eye to keep it steady during the procedure. You may experience some discomfort (typically a pressure sensation) during this part of the procedure. The total procedure, including the presurgical preparation, is usually completed in less than one hour.
After INTACS inserts are placed in your eye, your doctor will put some drops or ointment into your eye to reduce swelling. Your eye may then be covered for your protection and comfort. You may experience some discomfort or pain in your eye following the procedure. Most patients describe their discomfort as moderate and it typically diminishes within 48 hours. Your doctor may recommend a medication to help ease your discomfort. Please remember to make arrangements for transportation as you should not drive the day of your procedure.
The First Weeks After the Procedure
Your doctor will typically examine your eye the day following your procedure. You will be mildly sensitive to light and will have the feeling that something is in your eye for the first few days. Sunglasses may make you more comfortable during this time.
For the first few weeks following the procedure, your eye will be healing. During this time, you will need to take special precautions with your eye to keep it clean and to protect it from injury and infection.
Your doctor should prescribe an antibiotic to be used following the procedure. Apply the antibiotic directly into your eye as instructed. Your doctor may prescribe steroid drops for the first week or two following the procedure to decrease irritation and redness of your eye.
Use the steroid eye drops and lubricants, as instructed by your doctor. Your surgical results depend upon following your doctor’s directions.
Your doctor may recommend that you wear an eye shield at night. The shield should be worn to protect your eye from irritation and injury, such as rubbing or scratching, while you sleep.
Most patients do not experience significant pain following the procedure. If you do experience pain, ask your doctor about taking medication, such as a pain reliever, to ease the discomfort. Other pain medication may be prescribed by your doctor.
Benefits of Intacs
- INTACS inserts may improve your vision by creating a more regular surface for your cornea, which may allow you to be successfully fitted with contact lenses, glasses or both.
- INTACS inserts may reduce the nearsightedness and astigmatism associated with your keratoconus.
- INTACS inserts preserve the central part of the cornea which is most important for your vision.
- INTACS inserts may defer the need for a corneal transplant procedure.
- INTACS inserts can be surgically removed or replaced.
Cost and Financing for Intacs
Many leading medical insurance companies provide coverage for the INTACS procedure. Even though this procedure is covered by most insurers, we will discuss the financing options available to you should your insurance provider consider Intacs a non-covered service.
Is Intacs Right for Me?
If you are considering INTACS inserts, you must:
- be at least 21 years of age;
- have nearsightedness and astigmatism as a result of keratoconus;
- be unable to achieve adequate vision correction with contact lenses or glasses;
- have clear central corneas (for example: no scarring or infection present);
- have a corneal transplant procedure as the only remaining option to improve your vision;
- be informed of the risks and benefits as compared to other available treatments for vision correction associated with keratoconus; and
- be willing to sign an informed consent form and to understand that the effectiveness of using INTACS inserts in treating patients with keratoconus has not been established, that the INTACS procedure is likely to only temporarily stop the progression of your keratoconus and that you may still be required to undergo corneal transplantation as the next course of therapy.
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Important Safety Information for Intacs
Intacs corneal implants are indicated for use in the correction of nearsightedness and astigmatism associated with keratoconus where contact lenses and glasses are no longer suitable. Intacs corneal implants are approved by the FDA for keratoconus under a Humanitarian Device Exemption (HDE).
Although initially approved for elective refractive surgery, ophthalmologists use Intacs “off-label” as a therapeutic treatment for the myopia and astigmatism that accompanies post-LASIK ectasia. Intacs do not provide a full correction or a full reversal back to your eye’s normal state. Rather, the goal is to reduce your myopia and astigmatism and /or alter the shape of your cornea so that you can be fitted for contact lenses. Intacs can be removed and replaced if the results are not satisfactory, or if you want to have them removed.