Keratoconus treatment

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Keratoconus is a severe disease when the eye cornea is bent into a cone shape. The reason for this is the thinning of the cornea. The condition is often asymmetric (one eye may be more affected than the other). Ophthalmologists treat corneal changes surgically (corneal transplantation) and conservatively (using glasses and lenses).

Keratoconus is an eye disorder when the cornea thins and forms a cone. This condition significantly impairs vision and distorts the image. The disorder occurs in 1 in 2,000 people, both men and women. However, it is more common in children than in grownups. Also, according to statistics, keratoconus is the second most common reason for corneal transplantation.

Such eye protrusion belongs to a group of diseases of the cornea, the so-called keratopathies. They are congenital or acquired and have different causes. Keratoconus is dangerous because, if not adequately treated, it leads to dire consequences:

  • Astigmatism;
  • Dropsy of the cornea;
  • Corneal rupture;
  • Vision loss.

Ophthalmologists distinguish between the following forms of keratoconus:

  • Silent - occurs ten times more often than the other form. It is so named because it, as a rule, causes no symptoms.
  • Progressive - usually becomes noticeable during adolescence and is characterized by uneven protrusion of the cornea.

Doctors also divide corneal damage into:

  • Stage 1 (early) - corresponds to a latent form, when the disease does not manifest itself.
  • Stage 2 (moderate) - corneal distortion is noticeable, and the quality of vision begins to decline.
  • Stage 3 (advanced) - significant changes in the cornea and complaints.
  • Stage 4 (severe) - severe thinning and scarring of the cornea.

Each case of keratoconus is individual because the disorder develops at a different rate and differently in each eye.

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What is the cause of keratoconus?

The causes of the disease are varied from case to case. The condition can occur due to the influence of genetic predisposition, environmental factors or for such reasons:

  • Eye injury;
  • Metabolic disorders in the body;
  • Taking certain drugs (hormones);
  • Connective tissue defects.

Ophthalmologists also identify factors that increase the risk of developing keratoconus:

  • Excessive eye rubbing;
  • Prolonged exposure to ultraviolet sunlight;
  • Genetic predisposition (approximately 10% of patients with this condition have a family member with the same disorder).

What symptoms do patients suffer?

Keratoconus significantly affects life and impairs its quality. Due to the deterioration of vision, driving a car or reading is impossible without proper treatment. This condition begins with cornea changes in the form of small areas of stretching and thinning that progress and cause symptoms such as:

  • Blurred vision;
  • Double vision;
  • Redness;
  • Tearing;
  • Itching;
  • Headaches;
  • Photophobia (increased sensitivity to light and glare).

In addition, every second patient suffers from hypersensitivity and dry eyes.

The most typical complaint is a sudden decrease in vision and slow progression of the disease, first in one eye, then in both. As the protrusion progresses, the cornea becomes progressively thinner. It can cause it to tear and leave a scar. Such weakens visual acuity in the long term. However, there may be an acute form when the wall of the cornea breaks suddenly and moisture flows out.

How do eye spesialists diagnose keratokonus?

Early diagnosis of keratoconus is essential for the timely prevention of visual impairment. Diagnosis begins with an eye examination under an ophthalmic microscope (ophthalmoscope). In the initial stages, the disease often disguises itself as myopia, so doctors begin treatment for myopia. However, if patients complain to the eye doctor about unsuccessful vision correction with glasses or lenses, this is already a warning sign and requires further investigation.

Modern clinics have equipment called a keratograph. This device estimates the thickness of the corneas and creates its model. Another method is the topography of the cornea (keratotopography) with a unique device that makes a coloured relief of the heights of the cornea. In advanced cases, the protrusion is visible with the naked eye without any instrument.

Keratoconus treatment

Treatment options range from wearing glasses to corneal transplantation, depending on the stage, form and symptoms. The silent type of disease is often discovered by chance during an eye examination. As a rule, they require only medical supervision. Doctors may start progressive form therapy with contact lenses as they put pressure on the cornea. However, with a continued protrusion, wearing lenses becomes impossible.

Physicians have developed several types of lenses for different degrees of keratoconus. These can be soft (for mild and moderate stages) or hard (for advanced and severe conditions). Correction of symptoms with lenses is possible as long as the level of vision is sufficient.

Corneal collagen crosslinking (CCL or CXL) is a relatively common low-risk treatment. The operation lasts about 45 minutes and creates a mesh for the cornea using ultraviolet irradiation and Vitamin B2 eye drops.

An alternative to the previous method is the intrastromal corneal ring segment (ICRS) to stabilize the cornea. These are semi-circular rings that doctors place inside the eye. This operation is suitable for patients with symptoms such as myopia and astigmatism and when glasses and lenses no longer help.

Successful CCL and ICRS operations remove the protrusion and eliminate the need for a corneal transplant. Doctors might also recommend combining these methods for better results.

Corneal transplantation is used for stages 3 and 4 of the disease. Since the structures of the eye are microscopic, this requires special equipment. For this purpose, ophthalmologists use laser devices during the operation. It allows surgeons to achieve the highest accuracy and reduces the healing time. Donor tissue transplantation is divided into full or partial. It is worth mentioning that donor material is essential in corneal transplantation and influences the final result. Modern eye clinics have asses to corneal banks with plenty of corneas for each case.

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What to expect after being diagnosed?

With timely treatment, the keratoconus prognosis is favourable. That statement is achived thanks to many surgical solutions available. The long-term success of corneal transplant surgery is over 90%. The 5- and 10-year survival rates for corneal transplants are 74% and 64%, respectively.


What is the best treatment for keratoconus?

Ophthalmologists distinguish two approaches: surgical and non-surgical. When conservative methods do not work, one has to resort to operations. The best treatments for keratoconus are corneal collagen crosslinking and intrastromal corneal ring segment. Both operations take approximately 40 minutes, have a high success rate and are an alternative to corneal transplantation.

What is the success rate of a corneal transplant?

The rate of success for corneal transplantation is relatively high, over 90%. However, sometimes patients need multiple transplants as the grafts wear out.

Can I have a corneal transplant abroad?

Yes, sure. Many people go abroad for corneal transplants. In some specialized leading clinics, the transplant success rate reaches 95%.

Is corneal transplant surgery abroad better?

Definitely yes. Corneal surgery abroad is better, and the reasons for this are the availability of specialized eye disease clinics and transplant centres, extensive experience of ophthalmologists and corneal transplant banks.

Can I treat keratoconus without a corneal transplant?

Yes. In most cases, a corneal transplant is not necessary. There are alternative methods with the same success rate and lower risks of complications. These include corneal collagen crosslinking (creating a retaining mesh on the eye) and intrastromal corneal ring segment (introducing special semi-rings to support the cornea).

Where can I get Keratoconus treatment?

Germany, Turkey, Spain, Poland, Lithuania are among the best for Keratoconus treatment.

5 countries and 10 cities for Keratoconus