At Parkhurst NuVision, we do have vision correction solutions for patients with keratoconus who would like less dependence on glasses and contacts. The three vision correction procedures that you could consider with keratoconus are: Visian ICL, topography guided PRK, and INTACS.
ICL is a surgery where a lens is placed just beneath the surface of the eye. It can correct high amounts of myopia and high amounts of regular astigmatism, both which are seen in keratoconus patients.4 The ICL does not make any big changes to your cornea, so this is our most popular option for keratoconus patients wanting better vision without contacts or glasses. A recent study compared INTACS to ICLs and showed that ICLs were more stable and provided more predictable vision results.5
Topography guided PRK is gaining traction both in the United States and outside the United States as a treatment option for keratoconus patients. Topography guided PRK uses a laser to reshape the cone shape to a more natural shape. In order to reshape the cornea with topography guided PRK the laser will need to remove the tissue causing the abnormal shape. We have to remember keratoconus causes patients to have a thinner cornea, so this procedure can be done only if you have enough corneal thickness. This procedure will also not be ideal for advanced keratoconus or those with a very cone shape, the laser will not be able to normalize the shape in these eyes. Topography Guided PRK can be done at the same time of corneal cross linking or can be done after cornea cross linking. These two can work very well together as corneal cross linking makes the cornea strong and topography guided PRK makes the cornea a more normal shape.6 Corneal crosslinking, topography guided PRK, and ICLs may need to all be combined in order to give the best possible vision without glasses or specialty contact lenses.7
INTACS are an intrastromal ring that is inserted into the middle part of the cornea in eyes with keratoconus to provide structural support to the thin cornea. INTACS attempt to improve the corneal shape and provide slightly better uncorrected vision for those with keratoconus. Typically INTACS are used for patients who can no longer fit in their specialty contact lenses due to their cornea becoming an advanced cone shape. These patients want to try something before doing a corneal transplant and intacs could be a solution. These patients need to be watched closely over time, because the cornea can have excessive inflammation after this procedure.