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Keratoconus – there is a cure


Research into debilitating eye conditions such as keratoconus has advanced at such a pace over the past few years that the drastic solution of a corneal transplant can now be avoided for many patients. Two highly sophisticated treatments that AVC offers to correct keratoconus, collagen cross-linking and INTACS, involve a simple half hour procedure at the most with cross-linking being completely non-invasive.

Keratoconus affects around 1 in 2,000 and starts around the time of puberty. The surface of the cornea, which is normally round and smooth, begins to thin and stretch to form a cone-like bulge, which makes vision blurred and distorted.

Many patients suffering from keratoconus feel their options are very limited and in the past, this was certainly true. The irregular shape of the cornea means that glasses cannot correct vision, so for milder conditions rigid contact lenses are used because they are in direct contact with the eye, but these can cause discomfort quite quickly. This is exacerbated because sufferers often have very dry eyes, which makes it even harder to tolerate a rigid lens. More severe conditions could only be corrected by corneal transplant which is, by nature, an option with limited availability and suitability, not to mention desirability.

However, thanks to the work of refractive surgeons who specialise in corneal surgery such as AVC’s lead surgeon Mr CT Pillai, keratoconus sufferers can not only have their condition corrected, they can go on to have further vision correction treatment and do away with glasses and contact lenses for good, just like anyone else.

INTACS is a treatment option for mild to moderate keratoconus that is quick and highly effective. In a procedure that takes just 30 minutes, a micro-incision is made in the cornea and a tiny micro-thin clear insert is placed inside to flatten the cornea and reduce the optical distortion. INTACS are made from a biocompatible material so there’s no possibility of them being rejected by the body’s natural defences; they are also removable and exchangeable so should any changes be needed in the future, all that’s required is another quick, simple procedure.

Cross-linking works by a process called photopolymerisation. Riboflavin – simple vitamin B2 – administered to the cornea is activated by UVA light to create strong chemical bonds between collagen fibrils. This process stiffens and strengthens the cornea to return it to an even shape. After wearing a protective contact lens for four days the eye will start to settle and vision stabilises after about a month.

At this stage, keratoconus sufferers who want to free themselves from glasses and contact lenses for good can really see light at the end of the tunnel. When their prescription has become stable, depending on their age, they can have implantable contact lens or clear lens exchange treatment, just like anyone else.

Anyone concerned about the safety of this procedure should be completely reassured by the knowledge that the UV light exposure involved is comparable to the amount the eye is exposed to during a full day spent outdoors in the summer; there really is no need for concern about the risk of over-exposure.

So from what may have seemed like a dismal future of deteriorating vision and discomfort, keratoconus sufferers can look forward to a life filled with all the freedom that vision correction treatment brings.

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