Keratoconus

Keratoconus is a chronic progressive disease that gradually leads to thinning of the cornea. This happens as a result of the weakening of the connection between its middle layers. As a result, the cornea is deformed under the action of intraocular pressure, astigmatism and myopia develop, vision deteriorates. With pronounced changes, the cornea acquires a conical shape, hence the name of the disease. Over time, with the development of the process, swelling and clouding of the cornea may appear, which further complicates vision.  

The disease is manifested by a decrease in vision due to the development of astigmatism and myopia. Patients complain about the need to frequently change the optical power of glasses and the appearance of intolerance to soft contact lenses. It is characteristic that the described complaints initially concern only one eye.

With the further development of keratoconus, astigmatism increases and vision correction becomes incredible. The cornea becomes thinner and thinner to critical values. There comes a time when the thickness of the cornea becomes so small that it is not able to maintain a balance of intraocular and external pressure. Corneal edema develops, the situation becomes unsafe for the integrity of the eye.

The early stage of the disease until later was difficult to diagnose and could be missed.

In recent times, thanks to the emergence of new technologies for studying the cornea, keratoconus is diagnosed more often and in the early stages. Modern methods of studying the cornea make it possible to obtain a complete topographic map of the anterior and posterior plane (which is especially important, because the initial changes appear precisely on the posterior plane of the cornea) of the cornea, its thickness at any point with an accuracy of 1 micron!!  

So far, the only treatment for keratoconus has been corneal transplantation, performed at advanced stages of the disease. Most corneal transplant centers estimate that at least 15% of all corneal transplants are performed specifically for progressive keratoconus.

Today there is a possibility of therapeutic treatment of keratoconus. The new method is called Corneal Collagen Crosslinking with Riboflavin – CCC-R, or UltraViolet – Crosslinking – UV-X using a Seiler lamp.

Under the influence of a specially modeled and dosed ultraviolet light (A spectrum), a photochemical ionization reaction occurs and the decay of riboflavin molecules with the release of free atomic oxygen. In the presence of oxygen free radicals, collagen molecules cross-link into a single three-dimensional network covering almost the entire corneal stroma. This thickens the corneal tissue and stops the progression of keratoconus.

Biomechanical studies have shown an increase in the mechanical rigidity of the cornea by 328.9%!

As a rule, in addition to compaction of the cornea, as a result of the treatment, a flattening of the central part of the cornea and an increase in the uniformity of curvature are observed. This reduces the degree of astigmatism by about 2 diopters and improves vision. With the initial stage of the disease and a slight astigmatism, it becomes possible to use ordinary soft contact lenses, to achieve a comfortable and well-tolerated spectacle correction.

The emergence of a new therapeutic method for the treatment of keratoconus gives great hope to those who suffer from this disease.

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