Keratoconus

Keratoconus is the progressive thinning and steepening of the central cornea (clear part of your eye). Keratoconus occurs in about .15% to .6% of the general population. Onset of keratoconus most often occurs during the teenage years. The mean age of onset is age 16 years but onset has been reported to occur at ages as young as 6 years. In over 90% of the cases it is bilateral and rarely develops after age 30.

Patients often complain of distorted vision rather than blurry vision at both distance and near. Some patients report halos around lights and photophobia (light sensitivity). As the cornea steepens and thins, a patient experiences a decrease in vision which can be mild or severe depending on the amount of corneal tissue affected. Diagnosis of keratoconus is completed through a comprehensive eye exam and advanced corneal testing. Typically, vision loss can be corrected early by glasses; later, irregular astigmatism requires optical correction with firm contact lenses. Contact lenses provide a uniform refracting surface and therefore improve vision.

Ultimately cornea transplant may be necessary.  We are also involved in the development of new technology including the placement of Intacs, collagen crosslinking and Deep Anterior Lamellar Keratoplasty.

Treatments for Keratoconus

Contact Lenses – Soft and Rigid

Patients with very mild disease may initially be corrected with glasses or soft contact lenses. The vast majority of patients with keratoconus however need rigid contact lenses for adequate vision correction.

Many patients find their contact lenses uncomfortable and can only tolerate their contact lenses for only a short period of time. The main reason why this happens is that the cornea steepens and rubs against the lens causing an abrasion and light sensitivity.

Another reason this happens is that patients with keratoconus often have very dry eye and as the eye dries out there is no lubricating barrier between the lens and the cornea contributing to the patient being uncomfortable.

Intacs

Intacs are clear, arc-shaped plastic “stents” placed within the peripheral cornea. Originally FDA approved to correct low amounts of near sightedness, they are currently used to improve the cornea shape of patients with keratoconus or and irregular cornea shape due to LASIK complications. This indication gained FDA approval in 2004.

While some patients have experienced remarkable improvement in the shape of their cornea after this procedure, in general the majority of recipients experience an improvement in the tolerance of their contact lenses. The effects do appear to last some significant period of time.

Doctors at Cornea Consultants of Albany were the first in Northeastern New York to perform Intacs. We encourage you to personally discuss your candidacy with our doctors as well as your risks, benefits and alternatives to this procedure.

Collagen Crosslinking - Keratoconus

This is an experimental procedure that is currently being performed in which attempts are made to strengthen the cornea with riboflavin and UV light. This procedure is not presently approved by the FDA for use in the United States and is available under investigational protocol only.

This treatment appears to stabilize the cornea and effect some modest flattening of the steep keratoconic cornea. Progression of disease appears to be arrested for at least 2 years. Laboratory evidence performed to date by European investigators indicate that there is a resultant increase in collagen strength.

We encourage you to personally discuss your candidacy with our study coordinator and doctors.

Deep Anterior Lamellar Keratoplasty (DALK)

DALK is an additional newer method of corneal transplantation. It replaces only the superficial layers of the cornea. Candidates typically have keratoconus or other disease of the superficial layers of the cornea only. Success rates are approximately 50% due to the highly technical nature of this procedure. Fortunately, if the cornea does not divide optimally at the time of the procedure, a full-thickness keratoplasty remains an excellent option to rehabilitate vision. Potential advantages to DALK include greater structural integrity of the eye and decreased chance of rejection.

Please personally discuss the risks, benefits and alternatives of any corneal surgery with our doctors at Cornea Consultants of Albany.