Intacts for Keratoconus
What Is Keratoconus?
Keratoconus is a progressive eye disease, which causes a thinning of the cornea, the clear front surface of the eye. As a result of this condition, the normal outward pressure from within the eye causes the cornea to progressively bulge into a cone-like shape. Keratoconus rarely results in total blindness although it can significantly impair vision and, according to experts, lead to the need for a corneal transplant in up to 20% of cases. While nobody knows the cause of keratoconus, there is evidence that the disease has genetic origins, possibly made worse by environmental factors. It normally affects both eyes, though it typically progresses at different rates. In most people, keratoconus begins during their teen years and slowly worsens before stabilizing in their 30s or 40s. Researchers believe that approximately three million people worldwide have keratoconus. It affects males and females of all races. It is normally treated with rigid contact lenses which are contoured to address the bulging cornea and to improve vision.
Intacs Corneal Implants For Treating Keratoconus
As the disease progresses, the quality of one’s vision deteriorates and contact lenses or glasses no longer become a satisfactory solution for most people. For most keratoconus patients, an invasive corneal transplant was the only option – until now! Intacs corneal implants provide a unique new option to improve vision and defer a corneal transplant in most patients. Intacs are indicated for the correction of nearsightedness and astigmatism for patients with keratoconus, where contact lenses and glasses no longer provide suitable vision.
Benefits of Intacs for keratoconus patients
- Safe, removable, replaceable
- Reduces myopia and astigmatism associated with keratoconus
- Restores the cornea to a more natural dome shape
- Minimally invasive surgical procedure
- Recovery period is days, compared to months for a corneal transplant
- Improves quality of life
- May delay need for corneal transplant
Prior to any surgical procedure it is common to experience a degree of anticipation and anxiety. It may be comforting to know that 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. Dr. Wade has undergone a rigorous training program specific to Intacs and is one of the top Intacs surgeons in Texas and the U.S. for number of successful procedures.
Will Insurance cover this procedure?
Insurance Companies should cover all aspects of the procedure when performed for keratoconus in place of a corneal transplant. Even with substantial data published in the Peer-Reviewed Medical literature some insurers may not recognize the procedure for treating keratoconus. Technology is working to educate insurers, but this may take time. To the best of our abilities, we will obtain authorization from a patient’s insurance company to request reimbursement. However, all fees are ultimately the patient’s responsibility.
The National Keratoconus Foundation is a wonderful resource for keratoconus patients and families. They offer information and support through free, interactive online forums. These forums provide keratoconus patients with a unique opportunity to share their experiences, concerns and stories with others who can truly understand the challenges of living with this condition
Before the Procedure
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 Procedure for Intacs
Anesthetic drops are used to numb the eye, which is held open throughout the procedure to prevent blinking.
Step 1 A single, small incision is made in the surface of the cornea.
Step 2 The eye is prepared for Intacs placement.
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 in a narrow circular area to allow for Intacs placement.
Step 3 The Intacs inserts are gently placed.
After the second Intacs insert is placed, the small opening in the cornea is closed.
Step 4 The procedure is completed.
The placement of Intacs inserts remodel and reinforce your cornea, eliminating some or all of the irregularities caused by keratoconus in order to provide you with improved vision.
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.
Risks & Precautions
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. Patients with keratoconus must not have LASIK or PRK laser eye surgery due to an unacceptable risk of a poor outcome. The cornea in keratoconus is unusually thin and weak. For patients with keratoconus, LASIK surgery thins and weakens their corneas further. This can irreversibly destabilize the cornea and accelerate its distortion. Rubbing the eyes may also increase the progression of keratoconus. Eye rubbing can often be very vigorous with patients using excessive force with their knuckles. Corneas already weakened by inflammation may develop thinning and protrusion as a result of rubbing.
To view patient information brochure about Intacs, click here: IntacsPatientEducationGuide
In the U.S., corneal tissue is readily available for transplant surgery (unlike outside the U.S.). The procedure requires the removal of your corneal tissue, where the disease is most prevalent, and is surgically replaced with donor corneal tissue which is then sutured into place.
The procedure takes between one to two hours and will require multiple follow-up visits to assess the healing process to apply anti-rejection medications, complete the removal of the sutures and to perform a refractive examination and fitting for glasses or contact lenses. The overall recovery time differs by individual, however, the medical community indicates the recovery time can take more than a year.
Patients seeking professional, effective vision correction treatments visit Eye Center of Texas, a leading eye care practice in Houston. Led by Dr. Mayo and Dr. Wade, Eye Center of Texas offers LASIK eye surgery and cataract surgery in Houston and surrounding areas.