Keratoconus

PATHOLOGY

The Keratoconus is a degenerative, progressive non inflammatory eye pathology involving the cornea. It is an eye disorder which results in a thinning and deformation of the cornea in its central part and over time the corneal tissue loses its physiologic symmetry and takes the form of a cone (the name of the pathology derives from the Greek keras meaning cornea and the Latin conus meaning cone). It is a relatively rare pathology, with an important hereditary component, which usually arises in puberty and often involves both eyes. Men are struck more than women.The keratoconus presents several stages:  initialmediummedium-advanced and advanced. With the progression of the keratoconus, the cornea becomes increasingly irregular and this entails the arising of significant refractive defects, in particular the astigmatism, but very often also shortsightedness (in this case it is referred to as refractive shortsightedness).
At the initial stage, the visual defect produced by the keratoconus can be corrected with eye glasses. Later, when the curvature of the cornea becomes very irregular, the use is necessary of specific contact lenses for the keratoconus, which show high tolerability. When the keratoconus reaches a medium or advanced stage, several complications can arise: the contact lenses no longer adhere to the cornea and can no longer be worn (therefore, there is no possibility to correct the refractive defect in an optimum manner) and the corneal tissue continues becoming thinner, with the appearance of areas with scar tissue, with subsequent corneal opacification. The presence of scars and opaque areas interferes with the normal passage of light, may increase the refractive defects and often causes a sense of a very annoying glare.  In the advanced stage there is the risk of break of the Descemet membrane and corneal hydrops (acute keratoconus).

TREATMENT

The progression of the keratoconus stops spontaneously at approximately 30-40 years of age. In a small percentage of cases, however, the pathology worsens and makes a transplant of the cornea (Keratoplasty) necessary.

This surgery consists in the replacement of the deformed cornea with a healthy cornea obtained from a donor, even if as a matter of fact it would be more correct to speak of “grafting” rather than of a real transplant. The corneal transplant has a very high percentage of success, since the cornea has no blood vessels, therefore, graft rejection is possible, but in a very low percentage. However, it is appropriate to warn the patient about the risk of graft rejection always existing even many years after the surgery.   If the patient is able to recognize the symptoms in time such as pain, redness and worsening of vision, the transplanted tissue can be recovered and the patient can maintain his/her good quality vision he/she had prior to the surgery.

Today the objective is to find and develop techniques aimed at slowing down and containing the deformation of the cornea affected by keratoconus. Some of these techniques are already being used, however they are applicable only during the initial or intermediate stage of the pathology (e.g. Cross-linking), others are being validated (e.g. gene therapy). The patient who becomes ill today will always have the possibility to avoid the advanced stage of the pathology and reduce the need to be subjected to transplant, which was necessary till today’s date, but which it will be probably possible to avoid in the future.

WE CAN HELP YOU

If you believe that you are suffering from this pathology or you have any doubts that you wish to be clarified you can contact us.

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