Keratoconus is a serious vision-threatening condition where the front window of the eye (the cornea), slowly weakens and bulges outward into a cone-like shape rather than its normal spherical shape. Over time, this can lead to poor vision even with glasses or contacts, including contacts falling out of the eye frequently due to the irregular shaping of the cornea. Additionally, scarring of the cornea, and pain, and vision loss may occur. End-stage keratoconus may require a cornea transplant, a major surgery with significant risks during surgery and for the life of the patient.
Over the last few years, the management of keratoconus has evolved to include new treatments, including Intacs and crosslinking, which are some of the more common and accepted treatments currently. Intacs is a simple outpatient procedure that takes about 10 minutes to perform. This procedure involves placement of a small plastic ring in the eye to support the cornea and normalize its contour into a more spherical shape. Intacs often can help reduce the nearsightedness and/or astigmatism induced by keratoconus and enable younger patients to wear a soft contact lens. Older patients with cataracts and keratoconus to have a better outcome with this procedure after cataract surgery and be eligible for additional intraocular lens options.
Crosslinking is an outpatient procedure that takes about 30-40 minutes to perform and uses Vitamin B2 solution with an ultraviolet light to stiffen the cornea. It helps stop the progression of keratoconus and dramatically reduces the need for a cornea transplant in the future. It can be done before, after, or at the same time as Intacs. Depending on a few factors (age, the status of progression, the power of the eye, and corneal shape) a patient may need 1 or both treatments (Intacs and crosslinking).
Severe keratoconus patients may need a cornea transplant if they are not eligible for Intacs or crosslinking. This is often the case if there is corneal scarring or a history of corneal hydrops (prior rupture of the back of the cornea). Transplantation can be done with either full-thickness or partial-thickness techniques. Transplantation can generally achieve an excellent outcome with proper care, which includes regular and frequent postoperative visits & treatment with eyedrops for years to prevent rejection, as well as contact lenses and/or glasses.
At Pacific ClearVision Institute we investigate, learn and scrutinize the latest techniques and treatments for all of our patients here in the Greater Eugene, Oregon area. We strive to ensure that you, our community, have the best eye care options available to you. If you have keratoconus and want to discuss ALL of the options available to you, talk to one of our ophthalmologists and let us help you determine what the best treatment option is for you.