Keratoconus causes thinning of the cornea – the dome over the front of the eye – which can, over time, lead to this normally round dome developing a cone-shaped bulge. If you are diagnosed during the early stages of this progressive condition, you may only need glasses or contact lenses to correct the problem. However, as keratoconus can become worse as time moves on, it may become pertinent to explore treatment options. Read on to learn about the best ways to treat keratoconus.
However, it is important to note that this information does not replace the individualised information that would be provided by a specialist Consultant Ophthalmic Surgeon.
How does it affect vision?
As the cornea thins and changes shape, the eye becomes unable to focus properly, leading to poor vision. If the condition becomes advanced, individuals may develop corneal scarring, which added to the changes in shape of the cornea, reduces the amount of light that is able to enter the eye leading to blurred vision.
Corneal cross-linking (CXL)
Effective in over 90% of patients, this treatment can stop keratoconus getting worse. It uses ultraviolet light and vitamin B2 (riboflavin) drops to stiffen your cornea, preventing further thinning. Moorfields uses an ‘accelerated CXL’ treatment, which takes around just 20 minutes per eye to perform.
Corneal rings
Intracorneal stromal ring implants (ICRS) are placed in a laser-formed channel in your cornea, with the aim of improving its overall shape and reducing irregularity. You may require either one or two rings, depending on the severity of your keratoconus. This type of treatment is suitable for a select group of patients.
Transepithelial phototherapeutic keratectomy (TransPTK)
Refractive laser is not possible with keratoconus as it can make keratoconus worse. However, we can use a small amount of surface laser, termed TransPTK to flatten and smooth the surface of your cornea, that in some cases can help to improve its focus and sharpen vision while wearing glasses or contact lenses. This treatment is normally combined with corneal cross-linking unless previously performed.
Phakic intraocular lens implants
If you have good vision in glasses or soft contact lenses, intraocular contact lenses (ICL) in one or both eyes could work for you. This may not be effective in correcting your vision if you are dependent on rigid gas permeable contact lenses (RGP).
Corneal Transplantation
In more advanced disease the only options left is a corneal transplant. This is surgery to replace your cornea with a donated cornea. Although patients with keratoconus are in the best group for transplantation survival, this is usually a last resort. The recovery is 18 months to 2 years and is a journey to achieve the best corrected vision.
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