This article is more than 5 years old. Information may no longer be current.
Network of French centers develops national protocol for keratoconus management
Click Here to Manage Email Alerts
PARIS — Within the French national project for rare diseases, two reference centers and seven associated university centers in France are developing a national protocol for diagnosis and treatment of keratoconus.
"We are designing a decision tree for keratoconus," Joseph Colin, MD, said at the meeting of the French Society of Ophthalmology. "Mission No. 1 is keratoconus staging, based on keratometry, pachymetry, refraction and corneal transparency, graded 0 to 4. Visual acuity with spectacles, tolerance of contact lenses and disease progression are other key factors influencing treatment decision making."
Among treatment options, contact lenses are still first-line treatment, used in 90% of patients with stable keratoconus and transparent cornea. When contact lenses are not tolerated, intracorneal rings become the next treatment option.
"Progressive keratoconus is another branch of our tree, where the treatment of choice is now collagen cross-linking. We have now validated 5-year results proving that this treatment halts keratoconus progression in 97% of the cases," Dr. Colin said.
Early treatment is currently the trend, particularly in children, where cross-linking should be considered a sight-saving emergency treatment, he said.
The option of adding contact lenses or intracorneal rings for refractive purposes will depend on patients' contact lens tolerance.
A different branch of the tree comprises more advanced cases, where the loss of corneal transparency requires corneal transplantation, either lamellar or penetrating.
- Disclosure: Dr. Colin is a consultant for Addition Technology.