Keratoconus is an ectasia or a degenerative disorder of the cornea in which structural changes cause it to change to a more conical shape, modifying and progressively affecting the sight making it blurry. This process depends on the patient’s age at the initial symptoms. Normally, the younger the patient is, the faster the progression will become
There are different kinds of treatments according to the degree and stage of corneal deformation. The therapeutical options can be the following, depending on the case:
Contact lenses, when the glasses are no longer effective.
Cross-linking, a new technique to strengthen the cornea.
Corneal rings, when an intolerance of contact lenses is manifested and there are evident signs of keratoconus progression.
Cornea transplant, in more advanced stages where the other options do not seem to work. (Corneal scars , advanced keratoconus)
Cross-linking is a new method to treat keratoconus; it consists in producing new molecular bonds to reinforce the corneal collagen which becomes debilitated due to this condition. It is a great therapeutic alternative with excellent results and minimal side effects.
This technique consists in instilling a riboflavin drop until the cornea becomes completely impregned and then the application of UV radiation. The riboflavin creates a “filter” effect, improving the safety of this technique by not allowing UV light to enter the eye.
UV radiation, together with riboflavin, produces free radicals, which originate the corneal collagen strengthening (cross-linking). This is a non-invasive and simple procedure which is performed in an operating room on an outpatient basis.
Cross-linking can help you postpone or avoid a corneal transplant as it helps recover the corneal stiffness, and it is specially indicated for conditions such as keratoconus, iatrogenic ectasias and Marginal Pelucid Degeneration. It is also used to treat other corneal conditions and some infections.
What are the corneal rings?
It is a surgical treatment in which two acrylic semi-circular segments of variable thickness are implanted. This is considered the safest and least traumatic treatment for correcting keratoconus in some stages.
Thanks to their mechanical component, the corneal rings implants flatten the center of the cornea reducing the conical curvature and irregular astigmatism, causing visual improvement. Their purpose is to turn the cornea into a more spherical form improving glasses and contact lenses tolerance, and eventually, avoid a cornea transplant, as it is believed that this mechanical reinforcement will postpone this condition’s progression.
The corneal rings are suitable for patients of all ages who have keratoconus, patients who are contact lenses intolerant, with irregular astigmatism, and certain pathologies that lead to corneal deformation.
The surgical procedure with IntraLase lasts around 10 minutes, it is painless and it is done using anesthetic eye drops. Generally, there is a 24-hour recovery.
There are minimal risks; the procedure is reversible as the ring can be removed and the cornea can go back to its pre-operative shape. The next day your vision improves and it progressively stabilizes within the third month. You might need to wear glasses or contact lenses to complement the treatment.
The combination of both, the rings with the corneal Cross-linking technique is the optimal treatment for keratoconus and other corneal ectasias such as Marginal Pelucid Degeneration and the iatrogenics.
The cornea transplant, also known as keratoplasty, consists of replacing part or the whole patient´s corneal tissue for a graft coming from a deceased donor. This procedure is done in more advanced stages of keratoconus and when the other options cannot offer any improvement. (i.e. corneal scars, more advanced keratoconus, etc.)