Dr. Callahan is a competent professional who answered all my questions with patience. Her caring staff provided reminders and follow-ups. I had cataract surgery on both eyes; now 20/20 vision!
John Mcallorum
Intacs Corneal Ring Segments for Keratoconus
Who Is a Candidate for Intacs
Not everyone with keratoconus is an ideal candidate for Intacs. Your eye doctor will review your corneal measurements, imaging, and overall eye health to determine whether this treatment is right for you.
Intacs are typically considered when glasses and contact lenses no longer provide adequate vision correction. Ideal candidates generally have a maximum corneal steepness of 57 diopters or less and corneal thickness of at least 450 microns at the planned ring placement site. Central corneal scarring can affect results, since Intacs work best in clear corneal tissue.
Intacs tend to work best for patients whose keratoconus cone is located centrally or near the center of the cornea, causing regular or semi-regular astigmatism. Patients with very peripheral cones or more advanced scarring may not see the same level of benefit. Your eye doctor uses detailed corneal imaging and topography maps to predict how the segments will interact with your specific corneal shape.
Because Intacs alone do not stop progression, your eye doctor may recommend pairing them with corneal cross-linking (CXL). This combined approach addresses both the reshaping of your cornea and the stabilization of the disease. Your eye doctor will discuss timing and sequencing based on your corneal thickness and how quickly your keratoconus has been changing.
The Procedure and What to Expect
Intacs surgery is an outpatient procedure performed with numbing eye drops, so you remain awake and comfortable throughout. Knowing what to expect before, during, and after can help ease any concerns.
Your eye doctor creates precise tunnels inside the middle layer of the cornea, most commonly using a femtosecond laser for accuracy. The Intacs segments are then carefully inserted into these tunnels and positioned to reshape the corneal surface. The procedure takes approximately 15 minutes per eye and is performed on an outpatient basis, meaning you go home the same day.
Mild discomfort or light sensitivity is normal for the first day or two after surgery. Most patients are able to resume normal daily activities within one to seven days. Your eye doctor will prescribe eye drops to help prevent infection and reduce inflammation during healing, and follow-up visits in the first few weeks allow your care team to check ring position and monitor how your eye is healing.
Complications from Intacs surgery are uncommon, but they can include glare, halos around lights, or, in rare cases, ring migration or extrusion. Infection is rare when you follow your prescribed eye drop schedule carefully. If a ring segment causes persistent problems, your eye doctor can remove or exchange it in a short follow-up procedure.
One of the key advantages of Intacs over other surgical approaches is that they are removable. If your keratoconus changes significantly or your vision needs shift over time, your eye doctor has the flexibility to adjust your treatment accordingly.
Results and Long-Term Care
Intacs can produce meaningful improvements in corneal shape and visual function for appropriately selected patients. Your long-term outcomes depend on the degree of keratoconus, your corneal shape, and whether additional treatments are used alongside the rings.
Clinical studies have shown that Intacs can improve both uncorrected and best-corrected visual acuity in patients with keratoconus, and mean corneal astigmatism has been shown to decrease substantially following ring insertion. Patients with moderate keratoconus and clear corneas tend to experience the most consistent improvements. Individual results will vary, and your eye doctor will help set realistic expectations based on your specific measurements.
When Intacs are combined with corneal cross-linking (CXL), the two treatments work together to both improve corneal shape and slow or halt disease progression. CXL works by strengthening the collagen bonds within the cornea, which helps preserve the shape improvement the Intacs provide. Some eye doctors perform both procedures in the same session, while others prefer to space them several months apart, depending on the individual case.
If Intacs do not produce the expected improvement, or if your needs change as your keratoconus evolves, your eye doctor can reposition, exchange, or remove the segments. Removal generally allows the cornea to return close to its pre-surgery shape. This flexibility is an important feature that allows your care plan to adapt as your condition changes over time.
Frequently Asked Questions
We understand that patients considering Intacs often have specific questions about daily life, timing, and what to expect long term. Here are answers to some of the questions we hear most often.
Most patients do not feel the segments once healing is complete. Intacs sit inside the middle layer of the cornea, well below the nerve-rich outer surface. Some patients notice a mild awareness during the first few weeks after surgery, but this sensation typically fades as the eye adjusts to the new implants.
Intacs are designed to remain in the cornea for as long as they are providing benefit. Your eye doctor will monitor their position and your corneal health at regular follow-up visits. Because they can be removed or exchanged if your needs change, you are not committed to a permanent outcome, which makes them a flexible part of your long-term keratoconus management plan.
Most patients continue to wear glasses or specialty contact lenses after Intacs surgery to achieve their sharpest possible vision. The improvement in corneal shape often makes lens fitting easier and more comfortable than it was before the procedure. Your eye doctor will update your prescription after your cornea has fully stabilized, which typically takes several months.
Coverage varies depending on your insurance plan and policy. Because Intacs were cleared specifically for keratoconus treatment, many insurers consider them a medically necessary procedure. We encourage you to contact our office so we can help verify your specific coverage before you schedule your consultation or procedure.
Prior cross-linking does not prevent you from being considered for Intacs. In fact, a cornea that has already been stabilized through CXL may provide a more predictable foundation for ring placement in some cases. Your eye doctor will review your current corneal thickness and topography to confirm whether Intacs remain a suitable option after cross-linking.
Removal is performed as a short outpatient procedure similar in nature to the original surgery. After removal, the cornea generally returns toward its pre-Intacs shape over a period of several weeks. This does not close the door on other treatment options. Your eye doctor will reassess your corneal measurements after removal and work with you to determine the most appropriate next steps in your care.
Take the Next Step at NewView Eye Center
Our team at NewView Eye Center brings deep experience in treating keratoconus with advanced options including Intacs, corneal cross-linking, and additional corneal therapies tailored to your individual needs. We are proud to serve patients across Northern Virginia with personalized, physician-led care focused on preserving and improving your vision. Contact us today to schedule a consultation and find out whether Intacs may be the right solution for you.
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