Keratoconus Management

Introduction to Keratoconus.

Keratoconus is a condition that causes the cornea to weaken, get thinner and change shape. It affects between 1 in 3,000 to 1 in 10,000 people. The exact cause of the condition is unknown. There may be a genetic link, and it’s more common in people with multiple allergic conditions, such as eczema and asthma. Keratoconus usually appear in the early teens, but can occasionally occur earlier, it is usually mild and can be managed by using contact lenses or glasses. But in some patients it can progress to the point where a cornea transplant or other surgical intervention is necessary.

Prior to the emergence of Corneal Cross-linking (CXL), patients had to face corneal transplants in order to halt progression of the condition, and further vision deterioration. Today, the leading treatments are INTACS and Cross-Linking. The former can improve vision but the latter can halt progression of the disease and may be combined with laser eye surgery or implant phakic lOLsurgery to minimise residual refractive error and improve spectacle independence. CXL treatment could also be a treatment option for a rare complication of LASIK known as corneal ectasia. This complication occurs in less than 1 in 10,000 treatments and has become even rarer with advances in LASIK treatments.

Cross Linking Explained

The cross-linking treatment is a minimally invasive surgical procedure. It uses a UVA light system to harden the elastic corneal collagen filaments that have been infused with riboflavin (vitamin C) drops resulting in a strengthened cornea. After placing the drops on the cornea the eye is exposed to UVA light for 30 minutes. This enhances the bonds between the collagen fibrils to stiffen and strengthen the cornea. Following treatment and depending on whether the corneal epithelium has been removed a contact lens may be inserted for 4-5 days to allow the eye to heal. Only one eye is treated at a time due to the nature of the treatment and the variation in healing time.