Keratoconus
Using a cornea obtained from the Timor Eye Bank (USA), tested for various diseases, including Сovid infection. During keratoplasty, the doctor cuts open the damaged cornea and replaces it with donor corneal tissue. The cornea contains no blood vessels, and its compatibility is high compared to other tissues. After corneal transplantation, the development of keratoconus usually does not occur again. The process of complete recovery takes one year. Keratoplasty can be performed on one eye, and after a few months on the other eye.
What causes keratoconus?
It has not been established what causes keratoconus. Studies have shown that during keratoconus, the enzymatic balance of the cornea is disrupted and the stability of collagen fibers is compromised. As a result, the cornea becomes sensitive and bulges under the influence of intraocular pressure. Keratoconus may develop due to genetic predisposition or long-term exposure to ultraviolet radiation.
What is keratoconus?
Keratoconus is a degenerative corneal disease in which the cornea becomes thin and cone-shaped. The cornea is a transparent membrane in front of the iris, which normally has a spherical structure. In case of keratoconus the spherical shape of the cornea changes to conic, the cornea becomes thin and protrudes forward. The changes in the shape and thickness of the cornea result in changes in its optical function, worsening the eyesight - nearsightedness and high astigmatism develop. Keratoconus is characterized by progressive thinning of the cornea, and changes usually develop in both eyes.
What are the symptoms of keratoconus?
A patient with keratoconus may have one or more of the following symptoms:
- Blurred or unclear vision of objects
- Decreased visual acuity
- Diplopia
- Itching in the eyes
- Feeling of dryness in the eye
- Appearance of bright spots in front of the eyes
- Increased sensitivity to light
- Deterioration of night vision
- Sudden visual impairment
Keratoconus is most common in people between the ages of 10 and 25 and progresses over 10 to 15 years. By the age of 40, the disease stops developing in most cases.
How is keratoconus diagnosed?
The best and most accurate method of diagnosing keratoconus is corneal topographic examination, which uses Oculus Pentacam to perform a computerized corneal scan, measures corneal thickness and creates a topographic map of the anterior and posterior corneal surfaces. As a result, keratoconus can be diagnosed at an early stage.
Other ophthalmologic examinations may also be performed for diagnosis:
Eye refraction determination, a standard test performed with a computerized autorefractometer.
Biomicroscopic examination, using light directed at the surface of the eye, the cornea is examined and its shape evaluated.
How is keratoconus treated?
There are 4 stages of keratoconus, according to which treatment methods differ. In the early stages, glasses or soft contact lenses may be prescribed. In later stages, hard contact lenses can also be used, although this method does not guarantee to stop the progression of the disease. At this time, only the correction of reduced vision takes place. In case of stable, i.e. non-progressive keratoconus, phakic lens implantation is recommended to improve the quality of vision. If keratoconus is progressive in nature, surgical methods must be used.
“Crosslinking” - irradiation of the cornea with ultraviolet light.
Through crosslinking, additional connections are formed between the collagen fibers of the corneal stromal membrane, which contribute to the mechanical stability of the cornea and, as a result, strengthen the corneal layer.
The procedure is performed under local anesthesia - using anesthetic drops. Vitamin B2 (Roboflavin) is put into the patient’s eye and a special test is performed to make sure the sufficient amount of riboflavin is absorbed into the cornea, after which it is irradiated with UV-light (duration: 10 minutes). After the procedure, a soft contact lens is placed on the cornea and the patient is advised to use pain medication or antibiotics if necessary. This procedure is not performed on both eyes at the same time. If necessary, the procedure can be performed on the second eye 1-2 months after the first procedure.
Implantation of intrastromal corneal arches
During intrastromal arch implantation, small synthetic arches are inserted into the cornea and the corneal cone is aligned. As a result, it becomes possible to maintain the shape of the cornea and improve vision. The procedure involves making a small incision in the cornea and inserting the arcs. At the National Center of Ophthalmology, the arc implant procedure is performed with a Carl Zeiss femtolaser, which means that no surgical knife is used to make the incision, but the incision is made with a laser beam, which provides a safer and more accurate result. The laser beam can also be used for patients who are not having the standard method of surgery due to thinning of the cornea. The procedure takes only a few minutes and can be performed on both eyes at the same time.
Corneal transplantation, the same keratoplasty
Keratoplasty is performed when a patient is noted to have a far advanced form of keratoconus. At this time, a corneal transplant is performed - replacing the damaged cornea with a healthy donor cornea.
How common is keratoconus?
Studies show that keratoconus is not a common disease (affects 0.2% of the population).
Is prevention of keratoconus possible?
Unfortunately, keratoconus cannot be prevented. Therefore, a timely and correct diagnosis of the disease is important to provide appropriate treatment and avoid complications.
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