As we have seen here, keratoconus can lead to possibly serious eye damage . It is hereditary in nature, typically affecting young people in the prime of their active years. It has an incidence rate of one in 500. It is important to diagnose it as early as possible and implement modern therapies that block its development.
There is noteworthy social impact related to this disease: patients are catapulted into a new world of contact lenses, spectacles, partly empirical therapies and the certainty of progressive deterioration and the ultimate daunting prospect of a corneal transplant.
Already in 2010 a major international scientific journal “Cataract & Refractive Surgery Today” reviewed the state of the art in the treatment of keratoconus in the world with as special supplement:
As discussed later, two main approaches have been established for the treatment of keratoconus; they are instrastromal rings, corneal crosslinking and corneo-plastic surgery.
Diagnosis of Keratoconus
The patient will typically complain of disturbances to vision which can be attributed to the corneal surface which becomes irregular. It is, therefore, essential to study the cornea; its surface is evaluated with specific tests known as altitudinal corneal topography and pachymetry.
Altitudinal corneal topography evaluates the shape and the quality of the corneal surface (a computer photographs the cornea and processes the obtained images by creating a color map that represents the variations of slope and curvature of the front surface and, above all, the rear surface, the seat of onset of the disease).
Corneal pachymetry: a test that measures the thickness of the cornea in every point. It can be carried out with in-contact (ultrasonic) methods or by altitudinal topography, in a “no-contact” mode (without touching the eye).
Treatment of Keratoconus
The most advanced approach to the treatment of keratoconus is based on modern therapeutic technologies that block and stabilize the disease so as to avoid recourse to the cornea transplant procedure.
1 – Intracorneal prosthetics – Keraring – Intrastromal Rings
The intrastromal rings have the function of flattening the cornea and then reversing the corneal wear caused by Keratoconus.
2 – Simple trans-epithelial corneal cross linking or with Iontophoresis
The chemical-physical treatment known as simple trans-epithelial corneal cross linking or by iontophoresis, stimulates the renewal of the corneal cells (keratinocytes) which begin to produce healthy collagen.
The therapeutic effect is expressed as an increasing thickness of the cornea, in the reduction of the rear face ectasia and the reduction of the rear elevation.
To learn more about corneal cross linking, visit this page
3 – Corneo-plastic surgery
Corneo-plastic surgery is a new term that includes a group of biomechanical and surgical techniques. They improve the corneal anatomy, making it more similar to its natural physiological state, in a non-invasive but rather conservative manner.
Corneo-plastic surgery is a recently developed conservative corneal treatment characterized by: low invasiveness and low risk, rapid patient recovery and it does not exclude other surgical or diagnostic procedures.
See also the videos on keratoconus related to medical-surgical treatments.