Can Laser Surgery Treat Keratoconus?

Can Laser Surgery Treat Keratoconus?


What is Keratoconus?

Keratoconus is a degenerative eye disorder wherein the cornea, the transparent front surface of the eye, thins and bulges as keratoconus, progresses.This condition leads to the cornea adopting a cone-like shape instead of its usual dome-like structure.

Keratoconus can cause different visual aggravations, including obscured and twisted vision, expanded aversion to light, and trouble with night vision. In this note, we will dive into the causes, side effects, determination, and treatment choices for Keratoconus. Let us take a look at the overview of this disease.


Causes of Keratoconus

The exact cause of Keratoconus remains unknown, but several factors are believed to contribute to its development. These include genetic predisposition, environmental factors, and biochemical imbalances within the cornea.

Certain studies have identified associations between Keratoconus and conditions such as atopic disease, eye rubbing, connective tissue disorders, and a family history of Keratoconus. Additionally, hormonal imbalances and oxidative stress have been suggested as potential contributing factors.


Symptoms of Keratoconus

Keratoconus typically manifests during puberty or early adulthood, and its progression varies from person to person. The initial symptoms are often mild and may include blurred or distorted vision, increased sensitivity to light, and eye irritation.

As the condition advances, symptoms may worsen and include frequent changes in eyeglass or contact lens prescriptions, poor night vision, glare, and the appearance of halos around lights.


Diagnosis of Keratoconus

As we know early detection and diagnosis are very important for effective management of any disease thus also, Keratoconus. In this case an eye care professional performs a comprehensive eye examination, which may involve various tests, including:


Visual acuity test:
This test measures the sharpness of vision of the patient at different distances.


Corneal topography:
This maps the shape and curvature of the cornea, allowing for the detection of abnormalities.


Slit-lamp examination:
This test provides a magnified view of the cornea and other eye structures.


By this thickness of the cornea is measured.
Refraction test: The need for corrective lenses is determined.


Treatment Options

The treatment of Keratoconus depends on both the severity of the condition as well as its progression. Eyeglasses or soft contact lenses may be prescribed to correct mild visual impairments. As the condition progresses, special contact lenses, such as rigid gas permeable (RGP) lenses or scleral lenses, may be recommended to provide better vision by reshaping the cornea and improving its focusing ability.

In some cases, when contact lenses are not sufficient or well-tolerated, other treatment options may be considered, including:
Corneal cross-linking (CXL): A minimally invasive procedure that involves the application of riboflavin eye drops followed by exposure to ultraviolet light. CXL aims to strengthen the cornea and halt or slow down the progression of Keratoconus.

Intacs or corneal ring segments are small, crescent-shaped devices implanted into the cornea to reshape its curvature and improve vision.
Corneal transplant: A corneal transplant may be necessary in severe cases where vision cannot be adequately corrected through other means; this involves replacing the damaged cornea with a healthy donor cornea.

Thus, Keratoconus is a progressive eye disorder characterized by corneal thinning and bulging, leading to visual impairments. Although its exact cause remains unknown, genetic and environmental factors are believed to play a role. Timely diagnosis and appropriate treatment can help manage the condition and improve visual outcomes. Regular eye examinations and consultation with an eye care professional are crucial for individuals experiencing symptoms associated with Keratoconus.


Can Laser surgery treat Keratoconus?

Keratoconus, as we know it now, is a progressive eye disorder characterized by the thinning and bulging of the cornea. While treatment options for Keratoconus primarily involve using specialized contact lenses and surgical interventions.

Laser surgery has gained attention as a potential treatment modality. In this note, we will explore the role of laser surgery in treating Keratoconus, specifically focusing on two common laser procedures: photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK).


Laser Surgery Options


Photorefractive Keratectomy (PRK):
PRK is a laser eye medical procedure that reshapes the cornea’s bend by eliminating a meagre layer of tissue from its surface. This strategy means addressing refractive mistakes by further developing the cornea’s ability to centre. While PRK is generally used to treat nearsightedness (astigmatism), it can likewise be utilized in specific instances of Keratoconus.


PRK in Keratoconus:
PRK can be considered for individuals with mild to moderate Keratoconus who cannot achieve satisfactory vision correction with contact lenses. The procedure aims to reduce the corneal irregularities caused by Keratoconus, improving visual acuity and reducing astigmatism. PRK may also be combined with corneal cross-linking (CXL), a technique that strengthens the cornea and halts the progression of Keratoconus.


Laser-Assisted In Situ Keratomileusis (LASIK):
LASIK is a popular laser eye surgery procedure that corrects refractive errors by reshaping the cornea. Unlike PRK, which removes the cornea’s outer layer, LASIK involves creating a thin flap on the cornea’s surface, lifting it, and using a laser to reshape the underlying corneal tissue. The flap is then repositioned, allowing for rapid healing and minimal discomfort.


LASIK in Keratoconus:
LASIK is generally not recommended as a primary treatment for Keratoconus due to the cornea’s inherent instability in this condition. However, in some cases where Keratoconus is stable and mild, LASIK may be considered an adjunct procedure following corneal cross-linking (CXL). Combining CXL and LASIK can improve vision and reduce refractive errors.


Limitations to Consider-Can Laser Surgery Treat Keratoconus?

It is important to note that while laser surgery techniques like PRK and LASIK may provide visual improvement in certain cases of Keratoconus, they are not universally applicable or appropriate for all individuals. Factors such as the severity and stability of Keratoconus, corneal thickness, and the patient’s overall ocular health must be carefully evaluated before considering laser surgery as a treatment option.

Additionally, laser surgery for Keratoconus is not a curative procedure. It primarily aims to improve visual acuity and reduce refractive errors by modifying corneal shape. Regular post-operative follow-ups are necessary to monitor the progression of Keratoconus and adjust the treatment plan if required.

Therefore, Laser surgery, including PRK and LASIK, may be considered part of a comprehensive treatment plan for Keratoconus in special cases. However, its application is limited to specific situations where Keratoconus is stable and mild.

Consultation with an experienced ophthalmologist or corneal specialist is essential to determine the most suitable treatment approach based on individual factors. For most individuals with Keratoconus, specialized contact lenses, corneal cross-linking, and, in severe cases, corneal transplantation remain the primary treatment modalities.


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