Treatments for keratoconus vary depending upon the progression of the disease. Mild cases of keratoconus can often achieve good vision with eyeglasses or soft contact lenses. As the disease progresses, the cornea thins and changes shape. At some point glasses and contact lenses will no longer provide the best possible vision and other methods of treating keratoconus must be used.
Generally, rigid gas permeable lenses are the next method of treatment for patients with keratoconus. The firm material of hard contacts can maintain the spherical shape of the eye and allow for more focused vision. Fitting hard contact lenses for keratoconus patients requires a skilled practitioner. The fit can require more visits to achieve clear comfortable vision. This method of treatment for keratoconus is very popular for patients in the intermediate stages.
Some people with keratoconus can’t tolerate a rigid contact lens. They can be uncomfortable especially for people with advancing keratoconus. In many cases, contact lenses can no longer provide comfortable and acceptable vision. At this point, more aggressive treatment of keratoconus might be required in order to provide the vision desired.
A new treatment for keratoconus is corneal inserts. Intacs corneal rings had previously been FDA approved for low amounts of myopia but received FDA approval in August 2004 to be correct or reduce nearsightedness and astigmatism in keratoconus patients who can no longer obtain functional vision with contact lenses or eyeglasses. The procedure involves placing the inserts with the corneal stroma in the periphery of the cornea. The result is a flatter cornea and clearer vision.
Studies show that Intacs generally improve a patient’s best corrected vision. Intacs are removable and exchangeable and the procedure takes only about 10 minutes. In fact, Intacs can allow a patient with keratoconus to defer or even avoid a corneal transplant. If necessary, Intacs do not preclude having a corneal transplant later if necessary. Potential risks that a patient with keratoconus must consider are infection, glare and halos, and foreign body sensation. Many of these risks are already experienced by a patient with keratoconus prior to any treatment, but it is important to discuss the procedure with a surgeon to make sure you are a good candidate.
Another new treatment for keratoconus is known as Corneal Collagen Crosslinking with Riboflavin (Corneal Collagen Crosslinking with Riboflavin). This method works by increasing collagen crosslinking within the cornea. This treatment can be combined with Intacs to provide a combined effect and provide greater stability than one treatment alone.
The final method for treatment of keratoconus may be a cornea transplant, also called a penetrating keratoplasty. A donor cornea will replace the thinning cornea and can often provide stable vision. Even after a transplant, a patient will most likely need glasses or contact lenses for clear vision. With advancing technology, newer treatments of keratoconus are likely to provide even better vision and perhaps even cure keratoconus permanently.
