Management of keratoconus: current scenario

Abstract

Keratoconus is an ectatic corneal dystrophy and is a leading indication for corneal transplantation surgery worldwide. The disease was first described in detail more than 150 years ago by Dr John Nottingham, but the understanding of the disease and its management have undergone significant changes over the last few decades. Corneal specialists have adopted new techniques and technologies for the effective management of keratoconus, while adhering to the age-old concepts of contact lens fitting and penetrating keratoplasty. Lamellar keratoplasty has been revived with improved outcomes and devices such as intracorneal ring segments are being used to treat cases of early keratoconus effectively. This review article discusses the current scenario on the surgical as well as non-surgical management of keratoconus with a focus on the established, novel and emerging treatment modalities.

Big Bubble DALK After CXL in Keratoconic Patients

“…3 The "Big Bubble" technique for DALK allows cleavage separation between Descemet's membrane (DM) and posterior stroma by forceful injection of air into the deep stroma.…”

Six-month outcomes of corneal crosslinking with dextran-free isotonic riboflavin solution

“…This condition is characterized by corneal thinning and protrusion, progressive myopia, and irregular astigmatism (1) and has conventionally been treated using modalities, such as rigid contact lenses, intrastromal corneal ring segment implantation, and keratoplasty. However, current treatment objectives include not only improved visual acuity but also the prevention of disease progression (2) . Accordingly, corneal cross-linking (CXL) is a relatively new treatment method designed to increase the mechanical and biochemical strength of the stromal tissue via exposure of the ectatic cornea to riboflavin and ultraviolet-A (UVA) light (3) .…”

Update on Simultaneous Topo-guided Photorefractive Keratectomy Immediately Followed by Corneal Collagen Cross-linking for Treatment of Progressive Keratoconus

“…Other successful surgical techniques are currently in use such as intracorneal ring segments (ICRS) implantation, and deep anterior lamellar keratoplasty (DALK) while others have been proposed and tested in the past such as conductive keratoplasty (CK) and epikeratophakia. [1][2][3] Corneal collagen cross-linking (CXL) opened new chapter in treatment of keratoconus, in which combination of ultraviolet A (UVA) light with riboflavin as a…”