keratoconus-surgery-in-india

Keratoconus Surgery

 

It’s easy to neglect your eyes because they rarely hurt when there’s a problem. Having an eye test won’t just tell you if you need new glasses or a change of prescription, it’s also an important eye health check. A simple eye examination can spot many general health problems and early signs of eye conditions before you’re aware of any symptoms, many of which can be treated if found early enough. At AakashSuper Speciality hospital, we provide personalized and unbiased health care services to people from all walks of life. Aakash is one of the city’s modern and leading hospitals, offering the widest range of medical facilities under one roof.

What is Keratoconus?

Your cornea is the clear, dome-shaped window at the front of your eye. It focuses light into your eye. Keratoconus is when the cornea thins out and bulges like a cone. Changing the shape of the cornea brings light rays out of focus. As a result, your vision is blurry and distorted, making daily tasks like reading or driving difficult.

What causes Keratoconus?

New research suggests the weakening of the corneal tissue that leads to keratoconus may be due to an imbalance of enzymes within the cornea. This imbalance makes the cornea more susceptible to oxidative damage from compounds called free radicals, causing it to weaken and bulge forward.Risk factors for oxidative damage and weakening of the cornea include a genetic predisposition, explaining why keratoconus often affects more than one member of the same family.Keratoconus also is associated with overexposure to ultraviolet rays from the sun, excessive eye rubbing, a history of poorly fitted contact lenses and chronic eye irritation.

What are the symptoms?

Keratoconus often affects both eyes, and can lead to very different vision between the two eyes. Symptoms can differ in each eye, and they can change over time.

In the early stage, keratoconus symptoms can include:

  • Mild blurring of vision
  • Slightly distorted vision, where straight lines look bent or wavy
  • Increased sensitivity to light and glare
  • Eye redness or swelling
  • More blurry and distorted vision
  • Increased nearsightedness (when your eye cannot focus as well as it should).
  • Not being able to wear contact lenses. They may no longer fit properly and they are uncomfortable.

What is Keratoconus treatment?

In the mildest form of keratoconus, eyeglasses or soft contact lenses may help. But as the disease progresses and the cornea thins and becomes increasingly more irregular in shape, glasses and regular soft contact lens designs no longer provide adequate vision correction.

Treatments for progressive keratoconus include:

  • Corneal crosslinking: This procedure, also called corneal collagen cross-linking or CXL, strengthens corneal tissue to halt bulging of the eye's surface in keratoconus.

There are two versions of corneal crosslinking: epithelium-off and epithelium-on.With epithelium-off crosslinking, the outer layer of the cornea is removed to allow entry of riboflavin, a type of B vitamin, into the cornea, which then is activated with UV light.With the epithelium-on method (also called transepithelial crosslinking), the corneal epithelium is left intact during the treatment. The epithelium-on method requires more time for the riboflavin to penetrate into the cornea, but potential advantages include less risk of infection, less discomfort and faster visual recovery, according to supporters of this technique.

  • Custom soft contact lenses: These lenses are made-to-order based on detailed measurements of the person's keratoconic eye(s) and may be more comfortable than gas permeable lenses (GPs) or hybrid contact lenses for some wearers.
  • Gas permeable contact lenses: If eyeglasses or soft contact lenses cannot control keratoconus, then gas permeable contact lenses usually are the preferred treatment. GP lenses vault over the cornea, replacing its irregular shape with a smooth, uniform refracting surface to improve vision.
  • "Piggybacking" contact lenses: For keratoconus, this method involves placing a soft contact lens, such as one made of silicon hydrogel, over the eye and then fitting a GP lens over the soft lens. This ap-proach increases wearer comfort because the soft lens acts like a cushioning pad under the rigid GP lens.
  • Hybrid contact lenses:These lenses were designed specifically for keratoconus, and the central GP zone of the lens vaults over the cone-shaped cornea for increased comfort.Hybrid contact lenses provide the crisp optics of a gas permeable contact lens and wearing comfort
  • Scleral and semi-scleral lenses:These are large-diameter gas permeable contacts — large enough that the periphery and edge of the lens rest on the "white" of the eye. These lenses cover a larger portion of the sclera, whereas semi-scleral lenses cover a smaller area
  • Prosthetic lenses:Askeratoconic eyes are so challenging to fit, patients with severe disease often re-quire an advanced scleral lens design that doubles as a prosthetic shell
  • Intacs: This may be needed when keratoconus patients no longer can obtain functional vision with contact lenses or eyeglasses.Several studies show that Intacs can improve the best spectacle-corrected visual acuity (BSCVA) of a keratoconic eye by an average of two lines on a standard eye chart. The implants also have the advantage of being removable and exchangeable. The surgical procedure takes only about 10 minutes.Intacs might delay but can't prevent a corneal transplant if keratoconus continues to progress.
  • Topography-guided conductive keratoplasty: This treatment uses energy from radio waves, applied with a small probe at several points in the periphery of the cornea to reshape the eye's front surface. A topographic "map" created by computer imaging of the eye's surface helps create individualized treatment plans.
  • Corneal transplant. Some people with keratoconus can't tolerate a rigid contact lens, or they reach the point where contact lenses or other therapies no longer provide acceptable vision.The last remedy to be considered may be a cornea transplant, also called a penetrating keratoplasty (PK or PKP). Even after a transplant, you most likely will need glasses or contact lenses for clear vision
 

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