Keratoconus is a corneal disease in which the cornea becomes increasingly thinner and deformed. For this reason the patient has vision that becomes increasingly blurry and deformed over time. The younger you are, the greater the risk that keratoconus will progress. Keratoconusis a widespread disease that mainly affects young people . Today, technology offers many new treatment possibilities for Keratoconus. The most innovative therapies for keratoconus are presented here in a video interview with Doctor Badalà who introduced important innovations in the treatment of keratoconus in Italy.
Keratoconus: why it occurs
Keratoconus comes for several reasons. The two main ones are a genetic fragility in the structure of the cornea and for this reason it is a disease that often affects multiple members of the same family; the second well-established is a trauma that is repeated on the cornea , for example these are patients who often rub their eyes, rubbing the eyes ruins a cornea which is genetically more fragile. Injury to the eye can also be linked to an improper position during sleep . For example, sleeping on your stomach or on your side can in some cases be associated with damage to the cornea during the night following rubbing of the eye on the pillow. In some cases, people with keratoconus are also allergic and, suffering from itching and burning, tend to rub their eyes . Treating eye allergies in time is therefore essential to prevent the onset of keratoconus, especially in subjects who have family members with full-blown keratoconus.
Keratoconus: News on how it is treated
The first aim in treating keratoconus is to stop the progression of the disease. Stopping it is possible even without surgery. In some cases, in fact, it is enough to eliminate bad habits such as rubbing the eyes to stop the progression of keratoconus and observe an improvement in vision and corneal topography. Sometimes the trauma to the cornea is subtle and possible other sources of trauma to the cornea must be carefully looked for. Once all possible causes have been excluded and all risk factors corrected, if keratoconus continues to progress then cross-linking surgery is appropriate.
Cross-Linking surgery is a valid option to stop the worsening of keratoconus in cases where simply changing the patient’s habits is not enough to stop the disease. The purpose of cross-linking is to make the cornea more robust and therefore make its deformation more difficult. The cross-linking procedure stiffens the corneal skeleton. The skeleton of the cornea is made of collagen and cross-linking binds the collagen molecules together. The operation can be performed with different techniques, a specialized center will be able to advise you on the most suitable technique in the specific case. It is always advisable to try to eliminate any form of trauma before the cross-linking operation, because if the trauma to the cornea continues, there may be a worsening even after the cross-linking, which consequently makes it much more difficult. the treatment of keratoconus. Once it is established that the keratoconus is stable, action can be taken to improve vision. There are several options in this regard.
The insertion of some rings inside the cornea allows you to improve vision. These rings change the curvature of the cornea, making it more regular and therefore improving the patient’s vision or his ability to wear contact lenses. The operation is performed with the aid of a laser which creates a tunnel inside the cornea where these rings are then housed. There are different types of intrastromal rings (for example the INTACS or the Ferrara Rings) all made of plastic material but with different shapes and profiles. Based on the characteristics of keratoconus, the expert ophthalmologist will be able to advise you which solution is the best: a single ring, two rings, one model rather than another.
Phakic lenses are like contact lenses but are inserted inside the eye. These are usually used to correct myopia and high astigmatism. In keratoconus , myopia and high astigmatism are usually observed which in some cases can be corrected by inserting a phakic lens inside the eye. There are different types of phakic lenses, usually in these cases we use the Visian ICL or EVO Toric phakic lenses or the Artisan Toric. The Visian ICL or EVO are positioned behind the iris and in front of the lens, the Artisan are positioned in front of the iris. In no case are these lenses visible from the outside, the eye retains its natural appearance. Depending on the type of keratoconus, one type of phakic lens or another is recommended.
Customized Cataract Surgery
In patients with stable keratoconus who are over fifty years of age , cataract surgery with the insertion of a customized intraocular lens built specifically for the patient’s needs is a valid option as it allows the correction of vision defects that usually they are quite high. Also during cataract surgery, the cataract is removed and a standard intraocular lens is implanted inside the eye. In those who suffer from keratoconus there is the possibility of choosing a personalized contact lens . Basically, after having precisely collected all the data relating to keratoconus, a personalized intraocular lens is built in the laboratory which can, a bit like a contact lens, correct vision defects.
The cornea transplant today is no longer the invasive operation of a few years ago because it is a selective cornea transplant, the entire cornea is no longer replaced as in the past, only the diseased part of the cornea is replaced (lamellar cornea transplant or DALK ), leaving the healthy part of the cornea. This allows for much faster visual recovery and a much lower risk of rejection. In Keratoconus the diseased part of the cornea is the outermost part (the stroma) while the innermost part (endothelium) is healthy and then an anterior lamellar cornea transplant also called DALK is performed. Corneal transplant allows the permanent correction of visual aberrations linked to keratoconus. Today with a resumption of normal life, as a rule just two weeks after the operation. Today is therefore a time of hope for those seeking a cure for keratoconus. There are various innovative solutions and by turning to a cutting-edge center you will be able to have the most suitable solution for the individual case. An early diagnosis is essential to have the best results, so if you have a family member with keratoconus we recommend that you carry out a screening with an eye examination and corneal topography in a timely manner. We invite you to visit the testimonials section, where you will find the stories of keratoconuspatients operated with the most innovative interventions, in the hope that this may be of comfort and help.
Laser Keratoconus Surgery
The treatment of early and advanced keratoconus can take advantage of laser keratoconus surgery . Laser intervention in keratoconus is indicated in the presence of nodules or scars on the apex of keratoconus. Laser treatment of keratoconus in these cases can be of great help because it allows you to flatten and regularize the cone with an improvement in vision and/or a greater possibility of using contact lenses for keratoconus. Dr.Badala performs keratoconus laser surgery, together with crosslinking, in Milan and Catania .