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Nonprofit Lasik laser eye surgery patient advocacy with network of evaluated Lasik doctors and detailed laser eye surgery information.
Keratoconus creates an irregular cornea that is a contraindication for most refractive surgery, but can be treated with Intacs inserts and/or CrossLinking.

Keratoconus is a disease of the cornea that makes the cornea become weak and gradually bulge outward. Most often, this bulging is in the lower half of the cornea and first presents as astigmatism, however not all astigmatism is due to keratoconus. The abnormal curvature of the cornea due to keratoconus changes the cornea’s refractive power producing moderate to severe irregular astigmatism and blurriness of vision. As the condition advances, scarring of the central cornea may occur. In mild or early stages of keratoconus (forme fruste keratoconus), eyeglasses may correct the astigmatic vision. Approximately half of keratoconus patients have no negative lifestyle effects. The cornea stabilizes after a few years without ever causing severe vision problems.

As keratoconus advances, rigid gas-permeable (RGP) contact lenses maybe the only non-surgical way to achieve clear vision. Contact lens fitting of a patient with keratoconus requires much care and frequent check-ups, because the condition can worsen..

Keratoconus is a contraindication for conventional or custom wavefront Lasik, Bladeless Lasik, PRK, LASEK, Epi-Lasik, or any refractive surgery technique that removes tissue, due to the high probability that these procedures may further weaken a cornea affected by keratoconus.

RLE and P-IOL are lens-based procedures that neither add nor subtract from the cornea, however advanced keratoconus may require other surgery that would be best performed before RLE or P-IOL.

Currently, between 10-30 percent of keratoconus patients require PKP because of contact lens intolerance, poor results from other stabilization techniques, or because of scarring of the cornea that causes loss of vision. A corneal transplant is highly successful but requires a long healing period. After three years 90%-95% people with advanced keratoconus have success with corneal transplant.

Two new treatments for keratoconus that may significantly reduce the probability of the need for PKP, improve visual ability, stabilize the cornea, and halt or slow the progression of keratoconus have recently become available.

Intacs, which were originally used for refractive purposes, have caused stabilization in keratoconus patients and may be a good choice to reduce the possibility of keratoconus advancement. Keratoconus is an indication for Intacs as a therapeutic treatment, which adds material to the cornea. For keratoconus patients who are also myopic (nearsighted, shortsighted), Intacs can also correct up to 3.00 diopters of myopia in a normal healthy eye, but can correct significantly more refractive error in a eye affected by keratoconus. Additionally, by making the cornea more regular, patients who had become contact lens intolerant may be able to again wear contacts after Intacs.

Used as a therapeutic treatment for keratoconus and corneas that have become unstable or weak due to ectasia, CrossLinking is a technique where the eye is flooded with a riboflavin solution and exposed to ultra high frequency light. CrossLinking apparently causes the collagen fibrils to thicken, stiffen, and reattach to each other, making the cornea stronger and more stable. CrossLinking is a new and noninvasive therapy that has been showing significant improvement for some patients with keratoconus.

    Consider and Choose With Confidence

Last updated Saturday, August 18, 2012

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