KERATOCONUS AND CORNEAL SURGERY

Bulging cornea causes blurred sight

Keratoconus is an irregular deformation of the cornea. The lower part bulges out, causing less sharp vision or visual distortions. This may be associated with photophobia and light scattering. In severe cases, corneal clouding.

Keratoconus develops progressively

Keratoconus manifests itself during the adolescence, and develops progressively over a period of ten to twenty years. The origin is unknown. Keratoconus usually affects both eyes, but the aberration can also develop asymmetrically.

Keratoconus and other eye disorders

Keratoconus develops insulated, or together with other ocular or general diseases, such as trisomy 21 or certain disorders that affect connective tissue (Ehlers-Danlos disease). Do you have a distorted view? Make an appointment with Dr. Vryghem. He will determine the correct diagnosis, and he will check your eyes for other diseases.

Keratoconus treatment

Keratoconus does not necessary cause blindness, but your vision is undergoing an growing distortion due to the increasing myopia and astigmatism. The treatment of keratoconus depends on the severity of the condition. At first hard contact lenses and glasses can be a solution, in a later stage surgery is required:

The first step is to determine whether it is a progressive or non-progressive keratoconus. When it comes to a progressive keratoconus and inall patients who are younger than 20 years, a UV Crosslinking treatment is recommended to stabilize the keratoconus.
UV Crosslinking is a new treatment, which increases the stability of the tissues. This treatment is recommended in all patients younger than 20 years and in patients with progressive keratoconus.

• Visual rehabilitation techniques (publications Eurotimes and CRST Europe):

After a UV Crosslinking treatment, we strive to give patients a functional sight, there are several techniques that allow the patient to visually rehabilitate:

- Sometimes this can be achieved by glasses, however, there will usually be a visual distortion.

- Another possibility for visual improvement is to prescribe hard contact lenses.

- If no hard contact lens solution, or hybrid lenses scleralenses can be adjusted.

- For those patients who are contactlens intolerant or where contact lenses do not effectively improve the vision there are finally three surgical techniques for visual revalidation:

o-topography-guided surface laser treatment (PRK)

o phakic lens implant

o intra-corneal ring segments (ICRS)

• In the case of a strongly marked keratoconus the progressive deformation of the cornea can be so pronounced that light can not regularly be focused on the retina in those cases a partial or full transplantation of the cornea, the ultimate alternative:

• cornea transplant replaces the entire cornea with a healthy donor cornea;

• DALK replaces only the first anterior layer of cells of the cornea.

• UV Crosslinking, a new treatment, increases the stability of the tissues;
• Cornea transplant: replaces the entire cornea with a healthy donor cornea;
• DALK replaces only the first cell layer of the cornea.
• Visual revalidation techniques (articles Eurotimes and CRST Europe):
• After UV Crosslinking it is possible to stabilize or improve the patients vision by contact lens adaptation. There are hard, hybrid and sclera lenses.
• For patients who are contactles intolerant there are other options:
• Lasik, topography guided Lasik or PRK
• Implant techniques: lens implants: phakic IOL's
• ICRS, insertion of an archwise implant placed in the stroma;

Keratoconus summarized

• Keratoconus is a deformation of the cornea, and is expressed during adolescence.
• The lower part of the cornea bulges out, reducing sharpness of vision.
• There are several solutions to correct keratoconus.

Do you think you are suffering from keratoconus? Contact doctor Vryghem . Or visit our practice.