Objectives to describe the visual outcome of keratoconus managed with intacs implantation addition technology inc, fremont, calif and to define criteria that predict good outcome. This line has been suggested to be an accumulation of iron deposits from the tear film onto the cornea as a result of severe corneal curvature changes induced by the disease andor due to modification of the normal epithelial slide process. Their original application was for the refractive correction of mild myopia. Treatment of moderate to severe keratoconus with 6mm intacs sk. Objectives to describe the visual outcome of keratoconus managed with intacs implantation addition technology inc, fremont, calif and to define criteria that predict good outcome methods this retrospective, nonrandomized, comparative, consecutive case series studied 58 eyes of 43 patients with keratoconus managed by intacs implantation. The corneal pocket incision meridian was the preoperative steep meridian.
Use of intacs in patients with keratoconus is an effective and costeffective procedure. For keratoconus, intacs work by flattening the steep part of the cornea or cone to reduce vision distortions. This prospective, noncomparative study included 37 contact lens intolerant keratoconic eyes stage iiiii of 24 patients who underwent. Intacs insertion is a procedure used to correct for small refractive errors like nearsightedness or astigmatism irregularly shaped cornea or for keratoconus coneshaped cornea.
In this procedure, small plastic semicircular rings are placed beneath the surface of the cornea which help smooth the shape of the cornea. The corneal implants are designed for longterm vision correction. Alio jl, shabayek mh, artola a 2006 icrs intacs for keratoconus correction. Presented in part at the american academy of ophthalmology annual meeting, dallas, texas, october 2000. Intacs are two, arc like, pmma segments which were designed to be surgically inserted into the deep corneal stroma to flatten the central cornea. Intacs are fda approved for keratoconus and may improve vision by making the cornea more round again. Request pdf on aug 1, 2003, bsb wachler and others published intacs for keratoconus vol 110, pg 1031, 2003 find, read and cite all the research you need on researchgate. Thats a condition that makes the cornea, the clear front part of your eyes, bulge out like cones. This is mostly bilateral condition, girls between 15 20 years affected more, overall incidence rate estimated to be 0. Intacs are clear plastic arcs that help flatten the cornea to treat keratoconus. Addition technology inc, sunnyvale, california is 1 treatment option available for patients with keratoconus, especially. Both intacs and corneal transplant surgery are able to treat keratoconus. Twentysix subjects underwent singleeye treatment, and 24 subjects had both eyes treated. Pdf postintacs fitting for a keratoconus patient researchgate.
Request pdf intacs in advanced keratoconus to evaluate the surgical outcomes of microthin intracorneal ring segment intacs. Device description intacs corneal implants are an ophthalmic medical device designed for the reduction or elimination of myopia and astigmatism in patients with keratoconus kc so that their. Intacs can be replaced with differentsize implants or removed for good. To examine the safety and efficacy of intacs sk for moderate to severe keratoconus kc using femtosecond technology. Intacs are a wonderful treatment tool to deal with keratoconus and. Keratoconus, which was first described in detail in 1854, derives from the greek words kerato cornea and konos cone. Seventyfour eyes of 50 subjects 41 male and 9 female were evaluated. Click the blue links below to download and read the available pdfs. Intacs is to be a logical addition to the stepwise treatment of keratoconus that improves visual acuity and, in a number of patients, has negated the need for corneal transplantation thus far. Intacs inserts for treating keratoconus oneyear results joseph colin, md,1 be. Since, most patients have both procedures performed which are typically done on the same day. Title eyes levinger keratoconus managed with intacs, arch ophthal, oct 05 53 uusitalo treating keratoconus with intacs, jrs may 05 50 alio one or two intacs for correction of keratoconus, jcrs may 05 26 colin current surgical options for keratoconus, jcrs feb 03 0 tunc intacs. Treatment of moderate to severe keratoconus with 6mm. Narayana nethralaya was the first hospital to introduce intacs in the country in 2005.
Intacs is the trademark name for microthin prescription corneal implants designed for the reduction or elimination of myopia and astigmatism in patients with keratoconus. To compare the results of intacs with kerarings when used in combination with collagen crosslinking for the treatment of keratoconus. Title eyes levinger keratoconus managed with intacs, arch ophthal, oct 05 53 uusitalo treating keratoconus with intacs, jrs may 05 50 alio one or two intacs for correction of keratoconus, jcrs may 05 26 colin current surgical options for keratoconus, jcrs feb 03 0 tunc intacs for. It is a bilateral, and asymmetric, corneal degeneration characterized by localized corneal thinning which leads to protrusion of the thinned cornea. Intacs are very small clear plastic arcs that are designed to be inserted into the substance of the cornea in people who have keratoconus and who can no longer see properly with glasses or contact. Intacs and ferrara rings are the more popular types of commercially available icrs for the management of keratoconus, intacs is available in 150 arc length segments with a hexagonal crosssection and various sizes ranging from 0. Keratoconus and ectasia have been successfully treated with both intacs and corneal collagen crosslinking. Will intacs inserts inhibit progression, accelerate it, or have no effect at all. Keratoconus, we are participating in a formal study of the effect of combined intacs and cxl in patients with keratoconus or corneal ectasia after previous lasik or prk. The cornea is the clear window in the front of the eye see picture on the right. Intacs, corneal inserts for treatment of keratoconus and ectasia. Intacs inserts using the femtosecond laser compared to the mechanical spreader in. Intacs corneal implants are indicated for the treatment of keratoconus, to fully or partially correct myopia or astigmatism in patients that need to restore their visual function and for whom a satisfactory correction of vision with contact lenses or with glasses is not possible, and for patients who wish to avoid a possible. In this prospective, noncomparative, interventional case series study performed in dena hospital, shiraz, iran, thirtyseven eyes of thirtysix patients with moderate to severe keratoconus, clear central cornea, and contact lens intolerance were enrolled and underwent intacs sk corneal ring segment implantation.
A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Keratoconus intacs treatment canadian keratoconus foundation. Intacs surgical eye implants for keratoconus webmd. Keratoconus is a bilateral noninflammatory corneal ectasia with an incidence of approximately 1 per 2,000 in the general population. It has welldescribed clinical signs, but early forms of the disease may go undetected unless the anterior corneal topography is studied. Intacs are thin plastic, semicircular rings inserted into the mid layer of the cornea. Intacs is the trademark name for microthin prescription inserts which were previously used as a form of refractive surgery in the treatment of low levels of myopia or nearsightedness, but have recently received fda approval for keratoconus. Intacs can help reduce or eliminate myopia and astigmatism in keratoconus patients where functional vision is no longer obtained with contact lenses or eyeglasses. An educational video about how intacs corneal implants help keratoconus patients who cant wear their contact lenses avoid a. The product is designed with a fixed outer diameter and width. Intacs surgical instruments consist of a series of ophtalmic instruments that are designed for the placement of intacs corneal implants.
To achieve maximum impact on keratoconus and improvement in your vision. Longterm study must be conducted to ascertain the impact intacs inserts treatment has on the natural progression of keratoconus. Intacs in advanced keratoconus request pdf researchgate. Optical coherence tomography provides insight into the. The incision entry is closed with a single 100 nylon. Kaiser permanente medical technology assessment criteria.
Coverage issues guidelines and medical technology assessment recommendations are developed to determine coverage for avmed s benefits, and are published to provide a better understanding of the basis upon which coverage decisions are made. Physician booklet intacs corneal implantskc page 2 i. Complications of intrastromal corneal ring segments springerlink. Intacs instruments technical sheet intacs for keratoconus.
The use of intacs inserts in the treatment of keratoconus does not meet the. Management of keratoconus with intacs sciencedirect. Intacs inserts are placed under the surface of the cornea, preserving its structure and improving vision without the need for corneal transplant surgery. Given the significant cost and potential side effects of intacs, and the possibility that keratoconus can be more effectively treated with keratoconus contact lenses, such as scleral lenses, this surgical procedure should not be considered as the primary treatment option for keratoconus. For example, a recent study conducted in china showed longterm stability of postlasik corneal ectasia after crosslinking without any relevant side effects. Efficacy and safety of intacs sk in moderate to severe. Performance of the intacs inserts procedure, other than as specified in this booklet and the iintacs surgeon training manual for keratoconus, may result in an undesirable outcome. Keratoconus it is a clinical entity characterized by noninflammatory and noninfective, progressive, bilateral thinning of the cornea with ectasia of conical shape. Intacs segment is placed beneath the sinskey hook and carefully pushed forward with the intacs holder until the edge of the intacs has been advanced to 1 mm from the entry wound. Pdf intacs addition technology, des plaines, il surgery has become a standard procedure in the. Prospective, nonrandomized selfcontrolled comparative trial. Intacs surgery for keratoconus kc inserts treatment. Results of using intacs inserts for treatment of keratoconus must be compared with those currently achieved by pk.
What are the potential risks of the intacs procedure for keratoconus. In 1996, intacs technology, one of the first com panies that designed the icrs, received the ce certifica tion and later in 1999, the fda approval for the. Incision location and placement of intacs inserts for treating. Intacs corneal implants are an ophthalmic medical device designed for the reduction or elimination of myopia and astigmatism in patients with keratoconus so that their functional vision may be restored and the need for a corneal transplant procedure can potentially be deferred. Keratoconus nomogram is developed by ajl ophthalmic, s. Methods this retrospective, nonrandomized, comparative, consecutive case series studied 58 eyes of 43.
To evaluate the use of intacs microthin prescription inserts kera vision, inc. Answer intacs are clear plastic arcs that are surgically inserted into the eye. The study included 34 eyes of 34 keratoconus patients who underwent symmetric intacs sk icrs implantation. How is the intacs procedure for keratoconus performed. The result is improper focusing of light rays on the retina and impaired vision. Updates on managements for keratoconus sciencedirect. In moderate and advance cases of keratoconus, a hemosiderin arc or circle line, commonly known as fleischers ring, is frequently seen around the cone base. These tiny plastic inserts are placed just under the eyes surface in the periphery of the cornea and help reshape the cornea for clearer vision. Intacs are tiny arcshaped plastic braces that are surgically placed within the cornea to reshape the cornea. Keratoconus is a bilateral, asymmetric, chronic, initially progressive ectasia of the cornea characterized by steepening, distortion, and thinning of the apical cornea as well as corneal scarring.
A similar maneuver is performed for inserting the superior intacs segment. The use of intracorneal ring segments in keratoconus cyberleninka. Intacs corneal implants intacs corneal implants and intacs sk corneal implants. Keratoconus is a progressive eye disease that results in thinning corneal tissue, causing the cornea to lose its natural curvature. What are the potential risks of the intacs procedure for. Intacs for keratoconus vol 110, pg 1031, 2003 request pdf. Brian typically combines intacs with the holcomb c3r crosslinking system two techniques for keratoconus that he invented. Figure 1, whereas in eyes with central keratoconus intacs 0. Keratoconus is a bilateral noninflammatory corneal ectasia with an incidence of approxi. A modified intacs procedure was performed on subjects with keratoconus. Keratoconus 1 keratoconus this material will help you understand keratoconus, its causes, and how it may be treated. Intacs, corneal inserts for treatment of keratoconus and.
They are indicated for use in patients undergoing ophthalmic surgery requiring a lamellar dissection of the cornea. The goal of the clinical trial is to study the benefits and safety of the combined intacs and cxl as well as to evaluate the. Intacs for keratoconus official patient guide youtube. Sep 06, 2017 the result is improper focusing of light rays on the retina and impaired vision. To prospectively study the effects of the use of intacs microthin prescription inserts for the management of keratoconus. Intrastromal corneal ring segments combined with collagen cross. Intacs is the trademark name for microthin prescription inserts which were previously used as a form of refractive surgery in the treatment of low levels of myopia or nearsightedness, but has recently received fda approval for keratoconus. Answer this outpatient surgery is to insert a plastic arc in your eye to reshape the cornea. This study is being conducted under fda guidelines. The mean age of subjects in the study was 35 years, ranging from 20 to 73 years. Intacs are thin plastic, semicircular rings, which are surgically inserted under the surface of the cornea. It reshapes the cornea by flattening it closer to its original dome shape. Keratoconus is a condition that causes the cornea to thin and bulge out like a cone over time. Intacs, or corneal inserts, received fda approval for treating keratoconus in august 2004.