Keratoconus treatments are recommended based on individual circumstances taking into account the stage of progression, age and patient lifestyle amongst many other factors. New technology continues to push forward new and updated treatments for keratoconus with LaserVision boasting experts in this field.
Treatments available include:
Cross-linking is not a new technique and has long been used as a medical interventional technique in other areas such as dentistry. However, in recent years it has gained momentum in the treatment for stabilising keratoconus. First performed in 1997, it is now being used by a number of prominent ophthalmic surgeons here in Europe.
It is a non-surgical method utilising a UVA light source, which is delivered onto the cornea, together with a chemical mix largely made up of riboflavin for strengthening the collagen fibres within the corneal structure. The combination of the UVA light and the riboflavin creates a joining or bonding of the chemical structures within the cornea. The effect is similar to the change we commonly see when toasting bread. A fine slice of bread bends easily and has little strength but after toasting, the bread results in being stronger and slightly more compact.
This comparatively simple procedure has been shown in laboratory and clinical studies to increase the amount of collagen cross-linking in the cornea and subsequently strengthen the cornea.
Corneal segments are clear small, semicircular plastic rings of various thicknesses, which are inserted within the cornea at its outer edges. There are three main types on the market currently – Intacs, Kerarings and Ferrara Rings.
The insertion of corneal segments flattens the central area of the cornea and corrects myopic refractive errors. A major advantage of this procedure is that no tissue is removed and there is no ablation or incision across the visual axsis. They have been proven to stop or slow down the progression of keratoconus, although often glasses or contact lenses will be required.
The insertion of corneal segments is a surgical procedure and at LaserVision, we use the accuracy of the Femtosecond Laser to insert them within the cornea.
Advanced Topographic Guided Laser Treatment (T-CAT) is one of the most precise methods of reducing higher order abberrations in patients with keratoconus. Following sequential precise mapping of the cornea, the laser treatment is customised to follow the topography to gently remove the ‘peaks’ of corneal tissue in the most irregular areas. The cornea is then cross linked to stabilise it and ‘lock in’ the changes.
For patients in whom other methods of correction are not suitable, corneal transplant is an excellent option. This operation has been carried out for over 100 years, however in recent years this technique has been greatly improved.
The technique involves removing the misshapen corneal tissue and replacing it with healthy corneal tissue. It is a very successful technique with 90% of patients obtaining a great improvement in vision.