Keratoconus is a disorder of the eye in which the cornea gradually acquires a conical shape instead of the normal, gradual curve. There are several different treatments for this condition. In mild cases, glasses or contact lenses may provide adequate keratoconus treatment and vision correction. For more severe cases, types of keratoconus treatment include corneal inserts, corneal cross linking, or a cornea transplant.
The distortion of the cornea's shape affects the vision of patients, and for those with mild cases glasses or soft contact lenses can be usually all that's needed to address the condition. For patients who need more vision correction, there are a few other keratoconus treatment options. Rigid gas permeable contact lenses, or hard contacts, are often able to provide much more precise levels of correction because of the inflexible uniform surface they provide, but they can be uncomfortable.
One solution to this discomfort is to use "piggyback" lenses; this involves placing a soft lens on the eye first as a cushion, with a rigid lens over it. There are also hybrid lenses which combine a rigid center for vision correction with a soft skirt surrounding it for comfort. These lenses were designed specifically for keratoconus treatment and float over the surface of the eye for improved comfort.
A keratoconus treatment option for more severe cases is the use of corneal implants, also called Intacs. These are arc-shaped plastic devices that are inserted under the surface of the eye in the cornea. Once inserted, they help to reshape and flatten the surface of the cornea, thereby improving the patient's vision. They can be removed and replaced as needed, but they don't halt the changes in the cornea if keratoconus continues to progress.
Corneal crosslinking is one of the newest forms of keratoconus treatment. The U.S. Food and Drug Administration (FDA) started clinical trials of this procedure in 2008. It involves infusing the cornea with riboflavin eye drops and allowing them to soak through, then exposing the eye to UV light for a period of 30 minutes. This causes the crosslinks, which are bonds that link fibers in the cornea, to strengthen and stiffen. This treatment increases the strength of the cornea and appears to be a promising option for stopping the progress of keratoconus.
For the most severe cases, the best option for keratoconus treatment may often corneal transplant, also called penetrating keratoplasty. In this procedure, the distorted cornea is removed, and a new one is grafted in its place. To reduce the risk of rejection of the donor tissue, a procedure called endothelial keratoplasty can be used, which is a partial thickness transplant that leaves the innermost layers of the cornea intact.