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New treatment options for keratoconus
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The standard treatment of keratoconus was use of a rigid contact lens until it would no longer provide sufficient help, then on to a penetrating keratoplasty. There are now other options, from better contact lenses to new techniques of partial thickness transplantation to innovative ideas such as cross-linking. But with so many treatment options, there's still no perfect solution for keratoconus.
 Keratoconus. |
This patient presents to you with a history of bilateral keratoconus that was previously successfully treated with specialty contact lenses. Her optometrist was unable to get a good fit of the right eye, which now can only achieve a vision of 20/60 with the contact, but the fit is poor and the lens is unstable. The left eye still does well with a best corrected vision of 20/25 with the rigid contact lens.
Do you do a surgical procedure? If so, which? Do you recommend that the patient try to enroll in a cross-linking trial or wait until the technique has been improved? Or do you tell the patient to defer treatment since her other eye still sees well?