The procedures that follow are performed by a corneal surgeon in a day-surgery facility. We are fortunate to work closely with some of the best corneal surgeons in the country and part of our keratoconus management program is to provide referrals for these procedures where appropriate.
Corneal Collagen Cross Linking
One of the most exciting things to come out of the last 15 years of research into keratoconus is a treatment called corneal collagen cross linking (or CXL). This once-only treatment works by strengthening the links between the collagen fibres that make up your cornea.
This slows or completely stops the progression or worsening of your keratoconus. Even though the procedure is not without risk, and can take up to a year to achieve clearest vision, it is very appropriate to consider as it has been shown to reduce the risk of corneal transplant.
Intacs (intra corneal ring segments)
Intacs for keratoconus have been relatively popular now for roughly 15 years. This procedure was a failure for correction of myopia or near-sightedness and was resurrected as a treatment for conical cornea. The principle is that by implanting some small arcuate Perspex splints in the affected cornea, it is possible to reshape in a way that can improve vision.
This treatment has had limited success. Even though the shape of the eye is theoretically improved it does not mean that any extra vision is achieved to make one independent of contact lenses. In fact, contact lenses are often more difficult to fit after this treatment.
If all else fails, a corneal transplant (or graft) is a sight-saving procedure and can help keep many advanced keratoconus sufferers seeing well enough to live a full life. But surgery should not be taken lightly! Transplant should only be considered when an experienced, expert keratoconus contact-lens expert has failed to achieve a healthy, comfortable fit.
Like all surgery there are risks involved so where contact lenses are still suitable, it is best to continue with them, as contact lenses are often required even after a cornea replacement. Properly fitting contact lenses will nearly always provide far better vision than can be achieved with cross-linking, intra-corneal rings or a corneal transplant.