Intacs for Keratoconus

Keratoconus is a degenerative corneal disease, usually hereditary, and occurring in the twenties or thirties of a patient’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 patient vulnerable to infection and perforation of the cornea. If not treated blindness may eventually result.

Eventually, most patients who were initially corrected for Keratoconus-related vision difficulties with eyeglasses or contact lenses suffered 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.

Patients with Keratoconus must not have LASIK or PRK laser eye surgery due to an unacceptable risk of a poor outcome. For patients with keratoconus, LASIK surgery thins and weakens their cornea further. This can irreversibly destabilize the cornea and accelerate its distortion.

Keratoconus Surgeon

PictureIntacs are clear, micro-thin prescription
inserts made of biocompatible plastic

Intacs are clear, micro-thin prescription inserts made of biocompatible plastic. When placed between the layers of corneal tissue, they cause the central cornea to flatten, correcting mild nearsightedness. Intacs reshape the curvature of the cornea from within, working with the natural shape of the eye. With Intacs, no tissue is permanently removed from the cornea.

Intacs cannot be felt, are no more visible than a contact lens and require no maintenance.  They are the result of nearly a decade of clinical research and have been available worldwide for several years. Intacs are designed to be permanent, but they can be removed and even exchanged if vision needs change with age.

PictureIntacs are no more visible than contact lenses.

Florida Keratoconus surgeon Dr. Trespalacios, is Central Florida’s leading Intacs surgeon. 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. Clinical outcomes data shows that the use of Intacs™ has slowed the progression of the disease, which should obviate the need for a cornea transplant for most patients who are eventually treated in this fashion.

“Most of the patients that I have treated have experienced increased best-corrected visions, improved quality of vision, and a decrease in the decline in vision over time.” – Dr. Tres explains

Dr. Trespalacios recommends inserting Intacs by using a device known as the IntraLase laser: “This method utilizes a laser to create small curved incisional pockets in the cornea in which I insert the stabilizing device (Intacs™)”. The clinical significance for using the laser incision, or flap, 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; ultimately impacting the comfort, and recovery process to the patient.

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

Intacs are for those who:

  • Have keratoconus
  • Are at least 21 years of age
  • Are nearsighted
  • Have clear central corneas
  • Are glasses and contact lens intolerant

What to expect on surgery day:


You will arrive 30-60 minutes prior to your procedure. Once you have been checked in you may be offered a sedative to help you relax. You will then be prepared for surgery. The area around your eyes will be cleaned and a sterile drape may be applied around your eye. Anesthetic eye drops will be used to numb your eyes; no injections or needles will be used. When your eye is completely numb, an eyelid holder will be placed between your eyelids to keep you from blinking during the procedure.

PictureNext, a very small incision will be made and the two ring
segments will be inserted in the outer edge of your cornea.

Next, a very small incision will be made with the Intralase Laser and the two ring segments will be inserted in the outer edge of your cornea. During this process, you may feel a little pressure, but no pain. The small incision will bond itself using the natural outward pressure in your eye, without the need for stitches. The Intacs procedure takes about 15 to 20 minutes. Someone will need to drive you home. You should relax for the rest of the day. You may experience some discomfort, but this is usually alleviated with an over-the-counter pain reliever. Most patients resume normal activities within a day or two.

Realistic expectations

The decision to have Intacs inserted is an important one that only you can make. This procedure is designed to decrease the progression of Keratoconus and add stability to unstable cornea. You will still require glasses or contact lenses to see well.  

Serious complications with Intacs are extremely rare. Intacs is a safe and effective procedure, but like any surgical procedure, it does have some risks. After a thorough eye exam, you and Dr. Tres will determine if Intacs are an option for you. If you are a good candidate, you will be given additional information about the procedure that will allow you to make an informed decision about whether to proceed. Be sure you have all your questions answered to your satisfaction.