Keratoconus is a progressive eye disease which affects the shape of the cornea. As the condition progresses, the cornea thins and begins to bulge into a cone-like shape, causing blurred and distorted vision.
Keratoconus treatment stops this thinning and bulging. Treatment options vary by stage, as we discuss in detail further below.
How we treat keratoconus at each stage
There are three stages of keratoconus: early/ moderate, intermediate and advanced. In this section, we’ll cover the signs and symptoms of each stage and treatment options.
In the early stages, you may have no symptoms. During stage 1, we may recommend glasses or contact lenses to counter short-sightedness and astigmatism. Your contact lenses may be soft or hard.
The changes in the shape of your cornea become apparent in this stage. We may also notice corneal thinning.
We would often use cross-linking to prevent keratoconus from progressing further. This may be combined with laser treatment (called laser refractive cross-linking) to improve the quality of vision and reduce or regularise your astigmatism. Suitability for this treatment depends on your scans and the health of your eyes.
Stage 3 is the most advanced. You will likely have substantial corneal thinning and scarring at this stage. We may use corneal ring segments and corneal transplants (penetrating keratoplasty) to treat the keratoconus. Though, this is rarely needed since the introduction of cross-linking.
What is cross-linking?
We then soak the cornea in riboflavin (vitamin B2) drops and shine UV light on the cornea to activate the riboflavin. Together, these stiffen the cornea and allow fibres in the cornea to bond tighter (cross-link).
By increasing corneal rigidity, CXL stops the progressive thinning and bulge that develops in keratoconus and stabilises your vision.
At the end of the procedure, we place a contact lens on the eye, which we remove after 5-7 days. Your first follow-up appointment will be the day after your surgery. Watch our video – What is cross-linking for keratoconus? – to learn more about the procedure.
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 as CXL or C3R) is a treatment that strengthens the cornea and stops keratoconus from getting worse. Though, standard CXL does not focus on improving your vision.
Laser refractive cross-linking
In a select group of patients who meet the strict treatment criteria, we combine the cross-linking process with laser resurfacing. During laser refractive CXL, we reshape the cornea to improve your vision.
It may result in a reduced prescription and better glasses/contact lens corrected vision. Patients with early keratoconus may find that their vision improves enough that they are much less dependent on glasses and contact lenses.
What are corneal transplants?
In rare keratoconus cases, a corneal transplant may be needed. During corneal transplantation, we replace your cornea with that of a healthy donor. We can replace individual layers of your cornea or the entire cornea. We refer to this as partial or full thickness.
Common types of corneal transplant include:
- Deep Anterior Lamellar Keratoplasty (DALK) – replacing 90% of the front layer
- Endothelial Keratoplasty (EK) – replacing the back layer only
- Penetrating Keratoplasty (PK) – replacing the entire cornea
Learn more about the different types of cornea transplants on our cornea transplant surgery treatment page.
What are the benefits of keratoconus treatment?
Keratoconus treatment can quickly improve your vision and prevent further vision loss. Mr Tariq Ayoub discusses the numerous benefits of corneal cross-linking in our video below: What is the success rate of corneal cross-linking?
Additional benefits of cross-linking include:
- Proves suitable for thin corneas*
- Enhances contact lens tolerance
- Avoids corneal transplant
*We cannot perform the procedure if your corneas are very thin. Our specialist will inform you of your circumstances.
Cross-linking and corneal transplantation are safe and effective procedures with high success rates. Though, corneal transplants have more significant risks, such as rejection of the donated cornea, glaucoma, and retinal detachment.
Book an appointment
After a thorough consultation and corneal scanning, our specialists can determine the stage of your condition and the treatment required. Mr Ayoub will explain which stage of keratoconus you have reached and how we can prevent the condition from worsening.
If you want private treatment for keratoconus, book an appointment with Mr Tariq Ayoub.