Health Problem: Keratoconus is the most common corneal degenerative disorder. In keratoconus, collagen fibers within the cornea weaken and no longer maintain the normal round shape of the cornea. Consequently, the cornea bulges outward, steepens, and develops a progressive conical shape. This abnormal shape prevents light entering the eye from focusing directly on the retina, resulting in irregular astigmatism and progressive myopia or visual loss.

Technology Description: Treatment with Intacs involves minimally invasive surgery to implant 1 or 2 intrastromal corneal ring segments (ICRS) into the cornea of an affected eye through a single corneal incision. The implanted inserts do not directly alter the passage of light through the pupil, rather the inserts correct vision indirectly by stretching and flattening the cornea.

Controversy: Intacs may provide a treatment option for patients with progressive keratoconus, but the procedure may carry risks for complications. In addition, it is still unclear as to whether Intacs actually yield improvements in measures of visual acuity, corneal topography and thickness, refractive parameters, and quality of life.

Key Questions:

  • Do Intacs implants result in improved visual acuity and keratotomy measures?
  • Are Intacs implants safe?
  • How do Intacs implants compare with alternative surgical vision correction techniques?
  • Have definitive patient selection criteria been established for the treatment of keratoconus with Intacs?

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