Techniques to treat keratocons and improve vision acuity include the use of glasses, contact lenses, intrastromal corneal rings implants (INTACS), corneal cross linking with riboflavin, laser treatment to remove scars or nodules on the keratoconus apex, and, in the most serious cases, lamellar corneal transplant (perforating or full-depth).
In case of keratoconus, corneal topography is essential to decide which is the best treatment.Contact lenses and keratoconus: to start off, it is important to say that contact lenses do not slow down the progression of the keratoconus.
Contact lenses cannot slow down keratoconus progression: they only help to see better. Several kind exist: soft, rigid, semirigid, with variable geometry. A contactologist together with the ophthalmologist will advice you on the best kind of contact lens for your keratoconus situation.
To slow down keratoconus progression, it is best to avoid rubbing the eyes and, if it is in its initial phase, cross linking could be useful. Cross linking treatment is meant to make the cornea stronger, making it more difficult for it to change shape. It can be performed only on selected patients. There are several keratoconus surgical techniques.
Keratoconus laser surgery is suggested in case of nodules or scars on the keratoconus apex. Keratoconus laser treatment can be of great help because it flattens and regularise the conus along with vision improvement and/or higher contact lenses tolerance.
During the anterior lamellar transplant DALK, the damaged portion of the cornea is removed, leaving the healthy endothelium.
The main advantage is a faster convalescence and less complications. Dr. Badalà performs this kind of corneal transplant in Milan and Catania. In case of an initial conus or a conus that stopped at the initial phase, it can be possible to achieve a good vision quality even with glasses; in more serious cases, usually contact lenses have a good effect because they flatten corneal irregularities, but they cannot slow down the progression of the disease. During the initial phase, cross linking is important to slow down keratoconus progression. The next phase consists in laser surgery or intrastromal rings before and corneal transplant in a more advanced phase.
Corneas affected by keratoconus can be significantly different: every keratoconus differs from the others; there are also differences in perception from patient to patient.
Contact lenses and keratoconus: the first thing to say is that they cannot slow down the disease progression. Contact lenses cannot slow down keratoconus progression: they can only help to see better.
In case of keratoconus, corneal transplant is suggested when all of the other techniques failed. Lamellar corneal transplant helps for a quick vision recovery, has a lower rejection risk and a shorter post-op therapy, but it is far more complex than perforating transplant and in case of a very serious keratoconus may not be an option.
There are several solutions when speaking of keratoconus surgery: intrastromal corneal rings (INTACTS), corneal cross linking with riboflavin, laser to remove scars or nodules in the keratoconus apex and, in the most serious cases, lamellar corneal transplant o full-depth perforating corneal transplant.
The minimally invasive keratoconus surgery consists in the intrastromal rings or INTACS.
This rings made of a plastic material are placed in the peripheral portion of the cornea and flatten and regularize the central part of the keratoconus. Intrastromal rings can improve vision and/or contact lenses tolerance in case of keratoconus. The main innovation in keratoconus treatment is the anterior lamellar corneal transplant, also called DALK (Deep Anterior Lamellar Keratoplasty). that can be performed with several techniques. The most successful one, as several american authors say, is the big bubble technique.
There are several centers that can treat keratoconus in Italy. It is best to reach for a center that can perform all the different keratoconus treatment techniques. All the options complete one another.