Treatment of Keratoconus: News in March 2020

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Keratoconus is 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 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. 

Keratoconus: Symptoms, Causes and Prevention     

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 and the second well Keratoconus treatment: don't rub your eyes! repeated trauma to the cornea has been confirmed. 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 have been corrected, if keratoconus continues to progress then cross-linking surgery is appropriate. 

Cross-Linking   

Cross-linking 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. 

Intrastromal rings    

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 vision Intrastomal rings patient 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     

Phakic lenses are like contact lenses but are inserted inside the eye. These are usually used to correct myopia and high astigmatism. In keratoconus Phakic lenses Usually myopia and high astigmatism are observed which in some cases can be corrected thanks to the insertion of 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     

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 suffering 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. 

Selective Cornea Transplant     

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 part of the cornea healthy. This allows for visual recovery Selective corneal transplant: DALK much faster 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 section on Keratoconus for further information on the case and the testimonials section, where you will find  the story of patients with keratoconus operated with the most innovative interventions, in the hope that this can be of comfort and help.