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The elusive cure for keratoconus
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 Incisional corneal refractive surgery attempt in a keratoconic patient. |
 Keratoconic cornea destabilized by incisional refractive surgery. |
Ophthalmologists have been looking for treatments for keratoconus for many years, but still the cure remains elusive. Perhaps corneal collagen cross-linking with riboflavin will prove to be the best treatment yet, but in the meantime we can learn a lot by looking at less successful treatments.
With the mentality that refractive surgeons can fix just about anything, aggressive incisional techniques were used to address large degrees of astigmatism present in keratoconus eyes.
This patient has a total of 12 incisions in his cornea, each at 90%+ depth, with eight of them placed along a single axis to address astigmatism.
This was performed almost 20 years ago, and no old records are available from the surgeon, who has since retired. This treatment seemed to provide some initial help, but then the vision began to deteriorate as the cornea became further destabilized.
The patient now has a weakened cornea with a central thickness of 380 µm, a power of more than 70 D including 10 D of irregular astigmatism. At this point, he will likely need a corneal transplant.
See Dr. Devgan share more expert insight live at Hawaiian Eye 2012, to be held January 15-20, 2012 at the Grand Wailea Resort & Spa in Wailea, Maui. Learn more at OSNHawaiianEye.com.