Keratoconus
What is Keratoconus?
According to the AAO website, keratoconus is an uncommon condition in which the normally round, dome-like cornea (the clear front window of the eye) becomes thin and develops a cone-like bulge. Keratoconus literally means “cone-shaped cornea.” Keratoconus is a non-inflammatory eye condition in which the normally round dome-shaped cornea progressively thins causing a cone-like bulge to develop. This results in significant visual impairment.
Because the cornea is irregular and cone shaped, eyeglasses do not appropriately correct the vision in patients with keratoconus. This is a result of the glasses not conforming to the shape of the eye. It should be no surprise that patients with keratoconus see best with rigid contact lenses since these lenses provide a clear surface in front of the cornea allowing the light rays to be projected clearly to the retina. Therefore; the vast majority of patients are treated with rigid contact lenses. There are however some excellent new surgical options for patients with keratoconus who cannot tolerate these lenses. Many patients are initially unaware they have keratoconus and see their eye doctor because of increasing spectacle blur or progressive changes in their prescription.
The Causes of Keratoconus
The actual incidence of keratoconus is not known. It is not a common eye disease, but it is by no means rare. It has been estimated to occur in 1 out of every 2,000 persons in the general population. Keratoconus is generally first diagnosed in young people at puberty or in their late teen years.
CORNEAL COLLAGEN CROSSLINKING
The Doctors at Ophthalmology Associates are excited to be investigators for this revolutionary new treatment for Keratoconus and corneal ectasia. For more detailed information about this treatment please visit www.cxlusa.com or call the office at 314 966-5000.
BREAKING NEWS: Five-year data shows CXL can stop keratoconus progression
This prospective study evaluated long-term results of corneal collagen cross-linking (CXL) with ultraviolet A irradiation and riboflavin in 32 patients (40 eyes) with grades I through III progressive keratoconus. At five years, CXL halted disease progression, stabilized UCVA, refraction, corneal thickness, corneal power, and posterior elevation. Improvements also were noted in BCVA and anterior elevation. One patient dropped out due to an increase in BCVA and an inability to tolerate contact lenses or spectacles. No safety issues were noted. Ophthalmology, August 2013
NEW STANDARD: CXL should be considered in all patients with progressive keratoconus or corneal ectasia
Investigators analyzed a cohort of 104 eyes to determine preoperative characteristics that may influence outcomes from corneal collagen crosslinking (CXL) treatment. No factor was independently predictive of CXL failure. In general, eyes with worse CDVA and higher maximum K readings were more likely to improve. They conclude that all eyes be considered for treatment with the goal of stabilizing disease progression. Patients and physicians should be aware of the risk for loss of visual acuity.
Journal of Cataract & Refractive Surgery, August 2013

