Treatment of Keratoconus

Treatment

• Spectacles: Patients with early Keratoconus may have adequate vision correction with spectacles. As the disease progresses, glasses alone cannot correct vision completely.
• Contact lenses:

1. Soft toric contact lenses: Are useful initially for clear vision
2. Rigid gas permeable contact lenses (RGP lenses): Patients with modest-to-advanced Keratoconus almost always require rigid contact lenses.
3. Other types of contact lenses: Hydrogel contact lenses, piggyback contact lenses, rose K, or scleral contact lenses are used when rigid contact lenses are no longer tolerated.

• Intacs: These tiny plastic inserts in the periphery of the cornea and help re-shape or flatten the cornea for clearer vision.

Intacs may be needed when Keratoconus patients no longer can obtain functional vision with contact lenses or eye glasses.

This procedure is good for patients who are contact lens intolerant and who want to avoid a corneal transplant. This technique involves the insertion of two arc-like plastic segments into the middle of the cornea to flatten the cornea.

• Collagen cross linking: C3R is a procedure, which causes cross-linking between collagen microfibrils in the cornea. The procedure involves application of riboflavin eye drops to the cornea, which acts as a photosensitiser, then the cornea is exposed to UV-A radiation to generate free radicals within the cornea, which causes collagen cross links in the cornea making it stronger.

• Corneal transplants: In cases of advanced Keratoconus or corneas with opacities corneal transplant is a good option to restore vision in these patients. It involves removal of the diseased cornea and replacing it with a donor's healthy cornea.

• Phakic IOL: These are intraocular lenses inserted in the eyes of patients with Keratoconus for vision correction as these patients gradually become increasingly myopic.

Reference:

1. Gilbert Smolin, Charles Stephen Foster, et al., �Ectatic disorders of the cornea�, Smolin and Thoft's The cornea: scientific foundations and clinical practice, Pg-889.

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