Much like there is no cure for conditions such as myopia, hyperopia or diabetes there is no true “keratoconus cure”. However, with the keratoconus treatments now available the vast majority of keratoconus patients can experience good comfortable vision throughout the day. Here are some of the most succesful keratoconus treatment options.
Corneal Cross Linking
While corneal cross linking is not a keratoconus cure, it does strengthen the cornea. Cross linking strengthens the cornea by increasing the connections between the collagen fibers. This greatly reduces the progressive corneal steepening commonly seen in keratoconus. In some cases patients will experience a slight flattening of the cornea.1
Following cross linking, most patients will achieve their best visual acuity with the help of a scleral lens. While not a cure for keratoconus, scleral contacts have now become the most common and safest keratoconus treatment.
Scleral Contacts the Closest Thing to a Keratoconus Cure
What is a Scleral Contact Lens
A scleral lens is a contact lens that rests on the sclera, the white part of the eye, and vaults over the cornea. Scleral lenses are very comfortable since they don’t touch the highly innervated cornea. Instead, a scleral lens rests on the sclera and vaults over the cornea.
What Makes Scleral Lenses Special
Most patients with keratoconus are unable to achieve “normal” vision with traditional contacts or glasses. Scleral lenses help smooth out some of the corneal distortions which improves vision. While not quite a cure for keratoconus scleral lenses remove keratconus as a limiting factor to many activities, jobs, etc.
A corneal transplant, also called a penetrating keratoplasty, is a surgical procedure where a donor cornea is used to replace a damaged or diseased cornea. The need for corneal transplants has greatly decreased through the use of corneal cross linking and scleral lenses.2
When is a Corneal Transplant Considered
Corneal transplants are most often performed when there is no other way to improve the patient’s vision. Ocular pain from repeated episodes of corneal hydrops is another reason to consider a corneal transplant.3
Deep Anterior Lamellar Keratoplasty
If the deep layers of the cornea are in good condition then, rather than replace the entire cornea, only the outer layers are replaced. This is called Deep Anterior Lamellar Keratoplasty (DALK). When possible, this is preferred option over a corneal transplant. DALK has a lower rate of rejection and the corneal graft lasts longer.4
About Dr. Richard Driscoll
Dr. Driscoll is a therapeutic optometrist and keratoconus specialist at Total Eye Care in Colleyville, Texas. A 1988 Graduate of the Illinois College, Dr. Driscoll has been treating patients with keratoconus for over 30 years. Following Dr. Driscoll’s Graduation from the Illinois College of Optometry, he joined the residency program at the Tuscaloosa VA Medical Center in Tuscaloosa, Alabama. Dr. Driscoll likes to write. He wrote An Eye Doctor Answers: Explanations To Hundreds Of The Most Common Questions Patients Wish They Had Asked, available on Amazon.com.
1Randleman JB. Khandelwal SS. Hafezi F. Corneal cross-linking. Survey of Ophthalmology. Volume 60, Issue 6, 509-523. [PubMed]
2Koppen C. Kreps E. Anthonissen L. Van Hoey M. Dhubhghaill SN. Vermeulen L. Scleral Lenses Reduce the Need for Corneal Transplants in Severe Keratoconus. Am J Ophthalmol. 2018 Jan;185:43-47. [PubMed]
3Sarezky D. Orlin SE. Pan W. Vanderbeek BL. Trends in Corneal Transplantation in Keratoconus. Cornea. 2017 Feb; 36(2): 131–137. [PubMed]
4Karimian F. Feizi S. Deep Anterior Lamellar Keratoplasty: Indications, Surgical Techniques and Complications. Middle East Afr J Ophthalmol. 2010 Jan-Mar; 17(1): 28–37. [PubMed]