The use of Intacs as a therapeutic modality in contact lens intolerant patients with mild to moderate keratoconus is increasingly gaining acceptance in the ophthalmic community.During the past year we have gleaned significant new information about patients who are appropriate candidates, the location and relative placement of segment sizes and long-term safety and stability after Intacs placement. Another new and exciting development which will make this procedure safer and more commonly acceptable is the use of the femtosecond laser to create the channels to insert the Intacs, which has been described for the first time this year. This technology allows for accurate depth of inserting, improved outcomes and less complications due to superficial placement. New reports about Intacs revision surgery also allows us to retreat many patients who would otherwise have been considered surgical failures.The new advances described this past year will improve outcomes and ultimately contribute to an increase in the amount of physicians performing this procedure and the number of patients requesting it.