Treatment for Keratoconus
Treatment strategies for keratoconus include:
Contact Lenses
Contact lenses are the most effective form of treatment for most cases of keratoconus. Early stages of the disease with blurred or distorted vision can be corrected with soft contact lenses. Progressing keratoconus can be treated with rigid gas permeable contact lenses. If you cannot tolerate hard contact lenses, your doctor may prescribe piggyback lenses (hard lens on top of a soft one) or hybrid lenses (rigid center with outer soft ring). Advanced keratoconus and irregular changes in the cornea can be corrected with scleral contact lenses that rest on the white part of your eye (unlike other lenses) and cover the cornea without coming in contact with it.
Collagen Cross-Linking
Collagen cross-linking is an emerging treatment option for keratoconus. It involves applying vitamin drops to the cornea and exposing it to ultraviolet (UVA) rays. This therapy prevents further thinning or bulging and strengthens the cornea.
Lamellar Transplant
A lamellar transplant can treat scarring or excessive thinning of the cornea. The lamellar transplant involves replacing only a section of the corneal tissue with a donor graft tissue instead of the whole cornea. You will have to wear contact lenses for about one year during recovery. You will regain your full vision several years after the surgery.
Implantable Collamer Lens
Implantable Collamer lens is a biocompatible soft lens that can be permanently implanted into your eye. During the procedure, your doctor will inject the Collamer lens into your eye through a micro-opening. The lens will unfold and you will experience an immediate improvement in the quality of vision.
Intrastromal Rings
Intrastromal rings are also called as intracorneal ring segments or corneal inserts. Two tiny, crescent-shaped, clear plastic inserts will be inserted into your cornea to support the shape, flatten the cone and improve vision. This technique can slow the progression of keratoconus and restore the shape of the cornea to almost normal. This is a temporary measure as after the corneal shape is achieved, the inserts can be removed.
Hydrops Management
Keratoconus results in a rare complication called corneal hydrops. Hydrops occurs when the inner corneal layer (endothelium) ruptures and fills with fluid. This results in the cloudiness and swelling of the cornea. Hydrops can be managed by instilling antibiotic or steroidal eye drops to prevent infection, relieve pain and discomfort. In time, the endothelial pump cells will remove the fluid from the cornea.
