Early diagnosis and prompt treatment are a chance to stop the development of the disease
Correction of keratoconus is possible while improving visual acuity
The most specialized diagnostics
Innovative treatment methods
Keratoconus is a progressive disease, it affects both eyes in 90%. Cornea is the anterior and convex part of the eyeball. It consists of epithelium and endothelium which are separated with 2 elastic layers and stroma of the cornea. As a result of the disease, the cornea becomes thinner and cone-shaped. The protuberance of the cornea leads to deformation of its surface and vision disturbance.
Untreated keratoconus can make it necessary to transplant the cornea. Early diagnosis and treatment enable not only to stop development of conus but also to improve vision.
Methods of treatment
Hard and hybrid contact lenses
Keratoconus leads to development of irregular astigmatism which significantly affects quality of vision. The only way to correct the refractive error is wearing hard or hybrid contact lenses since eyeglasses do not improve vision. However, it should be kept in mind that contact lenses do not stop progression of the disease but only provide normal vision. The lenses are individually fitted, based on the examination which is called a corneal topography. Precision of lens fitting is extremely important for prevention of keratoconus compression and irritation of the cornea.
Cross Linking is an innovative method of keratoconus treatment. Cross-linking procedure is performed under local anesthesia with eye drops. It is carried out with or without abrasion (removal of corneal epithelium) and then tissue is soaked with riboflavin (vitamin B2) and subjected to UV light. As a result of this procedure, new crosslinks are formed between collagen fibers in the cornea. This leads to stiffening of the cornea, increasing its resistance to further deformations and strengthening it. After completing the procedure, a protective contact lens is sometimes placed and it should be worn until the first check-up.
An undisputable advantage of cross-linking is stabilization of keratoconus – the disease after the procedure stops to progress and it even happens that keratoconus becomes reduced. In order to qualify the patient for the procedure, keratoconus must be in the 1 or 2 stage of disease according to Amsler qualification. Cross-linking may also be performed after corneal transplantation in case of keratoconus relapse.
After the procedure, an appointment for a check-up is made and it is recommended to use specialist eye drops. An evaluation of a final cross-linking effect can be performed within 6-8 months from the procedure. Cross-linking is completely safe and does not cause any complications.
It should be kept in mind that keratoconus can develop in children as early as 8-10 years of age and cross-linking procedure can be performed at this age. There are no age limitations like in case patients who consider laser correction of a refractive error since cross-linking is believed to be a procedure which saves the cornea and thus vision.
Topoquided procedure is performed in order to better reshape the cornea and to eliminate keratoconus. It consists in laser smoothing of its surface, based on a topographic image of the cornea. The goal of the procedure is to make the shape more regular, thus minimize astigmatism and improve vision. Such procedure is usually associated with cross-linking.
Intacs rings are one of the methods of correcting keratoconus. They are selected based on the corneal parameters. A small incision is made in the cornea with laser and then an operator implants rings in the newly-formed channels. The implanted rings compress and flatten the corneal curvature. As a consequence, shape of the cornea becomes more correct and irregular astigmatism is reduced.
A decision on performing this procedure is taken by a doctor after performing a qualifying examination of keratoconus. Contact lenses should not be worn for at least 4 weeks before the examination.
The qualifying examination includes the following package of tests:
- Medical history
- Corneal topography
- Intraocular pressure
- Pupil width
- Visus s.c. and c.c. + pinhole vision
- Application of Tropicamide 1% eye drops according to a doctor’s recommendations
- Consultation with a doctor