Intacs for the Treatment of Keratoconus

 

Keratoconus is a degenerative corneal disease, usually hereditary, and occurring in the twenties or thirties of a person’s life. Keratoconus causes a generalized thinning and cone-shaped protrusion of the central cornea, not only resulting in poor vision, but also making the person vulnerable to infection and perforation of the cornea. If not treated blindness may eventually result.

 

Eventually, most people who were initially corrected for Keratoconus-related vision difficulties with eyeglasses or contact lenses in the early stages of Keratoconus. They would suffer from distortion with glare and cloudy vision, including impairment of night vision. Until now, only a cornea transplant has proven successful to offset the loss of visual acuity that these individuals would suffer from.

 

Dr. Wright began treating a number of Keratoconus patients by inserting an Intrastromal Corneal Ring (Intacs tm). The Food and Drug Administration has approved Intacs™ for the treatment of Keratoconus. The FDA approval specifically covers Intacs™ for reduction or elimination of myopia and astigmatism to restore functional vision in those patients with Keratoconus who are no longer able to achieve adequate vision with contact lenses or glasses. Most of the patients that we treat have experienced increased best-corrected vision, improved quality of vision, and stabilization of the deterioration. Clinical outcomes data shows that the use of Intacs™ has slowed the progression of the disease, which should eliminate the need for a cornea transplant for most patients who would have need a corneal transplant.

 

Dr. Wright choses to  inserting Intacs™ by using our IntraLase laser. Using the IntraLase laser to create the small curved incisional pockets in the cornea leads to increase stabilization of the Intacs™. The clinical significance for using the laser incision is that it provides a smooth and consistently guided depth in which to place the Intacs™ device, providing a less traumatic surgical impact to the cornea. This approach prevents scarring defects and helps to flatten the cornea, thus minimizing astigmatism and distortions in the visual outcome. The only other alternative is to utilize a hand instrument to hollow out the grooves in which the Intacs™ will rest. That process takes longer and the depth and curvature may be less consistent, which ultimately impacts on the visual outcome, comfort, and recovery process to the patient.

 

Dr. Wright believes that the use of Intacs™ administered by the IntraLase device will prove to be the standard of care for Keratoconus in the future.