Keratoconus Treatment

Overview  |  Options  |  Differences  |  Video FAQs |  Benefits |  Screening

There are two types of keratoconus treatment which are suitable to treat the eye condition in its early stages. These are cross-linking, and cross-linking combined with laser treatment which is called laser refractive cross-linking.

What is keratoconus?

Keratoconus is a progressive eye disease which affects the shape of the cornea. As keratoconus progresses, the cornea thins and begins to bulge into a cone-like shape causing blurred and/or distorted vision. Keratoconus treatment stops this thinning and bulging.

Keratoconus can occur in one or both eyes and often begins during a person’s teens or early 20s. It may be entirely asymptomatic initially with the earliest signs being increasing astigmatism.

Definitive diagnosis of keratoconus is made using scans of the cornea which often show the thinning and bulging typically seen in a keratoconic cornea.

Risk factors

Risk factors include a genetic predisposition, which is why keratoconus often affects more than one member of the same family. Keratoconus is also associated with eye rubbing and chronic eye irritation.

Keratoconus treatment options

In the early stages, keratoconus treatment options include the use of glasses and contact lenses to improve vision and a procedure called cross-linking.

Cross-linking stops the progression of keratoconus. Cross-linking can be combined with laser treatment (Laser refractive cross-linking) for improved outcomes in some patients.

In advanced cases, keratoconus can be treated with corneal ring segments and corneal transplants.

In selected patients with stable keratoconus, ICL implants may be used to improve vision and give them greater independence from glasses or contact lenses.

Difference between cross-linking & laser refractive cross-linking

The primary aim of both treatments is to stabilise keratoconus. However, there are some fundamental differences as explained below.

    Corneal cross-linking (also known CXL or C3R) is a treatment that strengthens the cornea and stops keratoconus from getting worse.

    By increasing the rigidity of the cornea, CXL stops the progressive thinning and bulge that develops in keratoconus and stabilizes vision.

    In a select group of patients who meet the strict treatment criteria, cross-linking (CXL) can be combined with laser resurfacing which is known as laser refractive CXL.

    This may result in reduced spectacle/contact lens prescription and improved spectacle/contact lens corrected vision.

    Patients with early keratoconus may even find that their vision improves enough such that they are much less dependent on glasses and contact lenses.

What are the benefits of keratoconus treatment?

There are a number of benefits of keratoconus treatment.

The benefits of cross-linking include:

  • Stops the progression of keratoconus
  • Prevents vision loss
  • Avoids corneal transplant
  • Enhances contact lens tolerance
  • Delivers fast treatment
  • Proves suitable for thin corneas
  • May improve vision

The benefits of laser-refractive cross-linking are as above but with increased chance of improved vision and reduced reliance on glasses or contact lenses.

Screening for Keratoconus

Very often keratoconus is detected incidentally during screening tests for laser refractive surgery. Presence of keratoconus disqualifies patients from having laser refractive surgery.

During your consultation, you will have a full eye assessment and scans of your cornea. Mr. Ayoub will explain to you the findings of the assessment and the treatment options most suitable for you if you do have keratoconus.

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    The aim of corneal cross-linking (CXL) is to stabilize keratoconus. After treatment, you will still need to wear glasses and/or contact lenses for clear vision.

    The whole procedure takes approximately 30 minutes for each eye. During the procedure, the surface layer of the cornea is removed. Mr. Ayoub prefers using layer (PTK) to remove this surface laser as it has been shown to improve the outcome of the procedure. After removal of this surface layer, the cornea is soaked in riboflavin (vitamin B2) drops. Following this, UV light is shone on the cornea to activate the riboflavin. At the end of the procedure, a contact lens is placed on the eye which is removed after 4-5 days

    The procedure itself is generally pain free as anaesthesia in the form of drops is used during the procedure to numb the eye. After the procedure you will be prescribed pain-killers for a few days to control any pain experienced.

    Generally most people are ready to return to work/general day-to-day activities after 1 week. However, heavy lifting and strenuous activity should be avoided for 2 weeks after the procedure. Mr. Ayoub will discuss your personal circumstances with you during your consultation.

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