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.
Corneal Cross-Linking (CXL) for treating Keratoconus
This minimally invasive, in-office procedure is also referred to as corneal collagen cross-linking. It’s designed to strengthen the cornea if it has been weakened, usually by keratoconus.
A healthy cornea has “crosslinks” that connect its collagen fibers, keeping it strong enough to retain its normal shape. Corneal cross-linking increases these crosslinks to help the cornea retain its normal shape and prevent further vision loss.
The CXL procedure applies liquid riboflavin (vitamin B2) to the surface of the eye followed by a controlled ultraviolet light. This is to eliminate corneal ectasia, which is mostly associated with keratoconus
Intacs 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.
- 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 a 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 Cross-Linking or Intacs 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.
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
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.