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Current review and a simplified "five-point management algorithm" for keratoconus.

Shetty R, Kaweri L, Pahuja N, Nagaraja H, Wadia K, Jayadev C, Nuijts R, Arora V - Indian J Ophthalmol (2015)

Bottom Line: Corneal collagen cross-linking is effective in stabilizing the progression of the disease.Topography-guided custom ablation treatment betters the quality of vision by correcting the refractive error and improving the contact lens fit.With such a wide spectrum of alternatives available, it is necessary to choose the best possible treatment option for each patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Cataract and Refractive Lens Surgery, Narayana Nethralaya, Bengaluru, India.

ABSTRACT
Keratoconus is a slowly progressive, noninflammatory ectatic corneal disease characterized by changes in corneal collagen structure and organization. Though the etiology remains unknown, novel techniques are continuously emerging for the diagnosis and management of the disease. Demographical parameters are known to affect the rate of progression of the disease. Common methods of vision correction for keratoconus range from spectacles and rigid gas-permeable contact lenses to other specialized lenses such as piggyback, Rose-K or Boston scleral lenses. Corneal collagen cross-linking is effective in stabilizing the progression of the disease. Intra-corneal ring segments can improve vision by flattening the cornea in patients with mild to moderate keratoconus. Topography-guided custom ablation treatment betters the quality of vision by correcting the refractive error and improving the contact lens fit. In advanced keratoconus with corneal scarring, lamellar or full thickness penetrating keratoplasty will be the treatment of choice. With such a wide spectrum of alternatives available, it is necessary to choose the best possible treatment option for each patient. Based on a brief review of the literature and our own studies we have designed a five-point management algorithm for the treatment of keratoconus.

No MeSH data available.


Related in: MedlinePlus

Pre- and post-operative day 1 images of a patient who has undergone femtosecond enabled keratoplasty
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Figure 9: Pre- and post-operative day 1 images of a patient who has undergone femtosecond enabled keratoplasty

Mentions: Femtosecond enabled the keratoplasty (FEK) is fast emerging as an alternative to manual or automated DALK. It has a higher precision with flexibility of wound construction in both the donor and the host cornea leading to better approximation and earlier wound healing. Our group has published the initial results of FEK with a 10 months follow-up.[44] We also analyzed all patients who have completed 2 years of follow-up with 40 eyes of 34 patients who underwent mushroom pattern FEK showing an improvement in UCDVA, CDVA, refraction and spherical equivalent [Table 7]. Wound edges had a good approximation with scarring by 4 months of follow-up allowing earlier suture removal and faster tapering of topical steroids. There was no evidence of graft rejection or primary graft failure in any of the cases [Fig. 9].


Current review and a simplified "five-point management algorithm" for keratoconus.

Shetty R, Kaweri L, Pahuja N, Nagaraja H, Wadia K, Jayadev C, Nuijts R, Arora V - Indian J Ophthalmol (2015)

Pre- and post-operative day 1 images of a patient who has undergone femtosecond enabled keratoplasty
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4363958&req=5

Figure 9: Pre- and post-operative day 1 images of a patient who has undergone femtosecond enabled keratoplasty
Mentions: Femtosecond enabled the keratoplasty (FEK) is fast emerging as an alternative to manual or automated DALK. It has a higher precision with flexibility of wound construction in both the donor and the host cornea leading to better approximation and earlier wound healing. Our group has published the initial results of FEK with a 10 months follow-up.[44] We also analyzed all patients who have completed 2 years of follow-up with 40 eyes of 34 patients who underwent mushroom pattern FEK showing an improvement in UCDVA, CDVA, refraction and spherical equivalent [Table 7]. Wound edges had a good approximation with scarring by 4 months of follow-up allowing earlier suture removal and faster tapering of topical steroids. There was no evidence of graft rejection or primary graft failure in any of the cases [Fig. 9].

Bottom Line: Corneal collagen cross-linking is effective in stabilizing the progression of the disease.Topography-guided custom ablation treatment betters the quality of vision by correcting the refractive error and improving the contact lens fit.With such a wide spectrum of alternatives available, it is necessary to choose the best possible treatment option for each patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Cataract and Refractive Lens Surgery, Narayana Nethralaya, Bengaluru, India.

ABSTRACT
Keratoconus is a slowly progressive, noninflammatory ectatic corneal disease characterized by changes in corneal collagen structure and organization. Though the etiology remains unknown, novel techniques are continuously emerging for the diagnosis and management of the disease. Demographical parameters are known to affect the rate of progression of the disease. Common methods of vision correction for keratoconus range from spectacles and rigid gas-permeable contact lenses to other specialized lenses such as piggyback, Rose-K or Boston scleral lenses. Corneal collagen cross-linking is effective in stabilizing the progression of the disease. Intra-corneal ring segments can improve vision by flattening the cornea in patients with mild to moderate keratoconus. Topography-guided custom ablation treatment betters the quality of vision by correcting the refractive error and improving the contact lens fit. In advanced keratoconus with corneal scarring, lamellar or full thickness penetrating keratoplasty will be the treatment of choice. With such a wide spectrum of alternatives available, it is necessary to choose the best possible treatment option for each patient. Based on a brief review of the literature and our own studies we have designed a five-point management algorithm for the treatment of keratoconus.

No MeSH data available.


Related in: MedlinePlus