The cornea is the first lens of the optical system of the eye. The health and transparency of the cornea is critical for a good visual function of the eye. There are many corneal diseases, some of them degenerative. Most of these corneal pathologies need a strict follow-up by a specialist ophthalmologist.
Keratoconus and corneal ectasia are progressive degenerative diseases of the cornea. To treat them adequately it is crucial to make an early diagnosis. It is fundamental to examine the patient with a last generation elevation corneal topographer and an Optical Coherence Tomography (OCT) so that we can diagnose and treat the ectasia at its early stages, stopping or delaying the progression of the disease.
Keratoconus and corneal ectasia are progressive corneal diseases. In the early stages all that is needed is to prescribe glasses or gas-permeable contact lenses to correct the irregular astigmatism that is common in these cases.
In some cases a surgical approach is needed:
Corneal Collagen Cross-linking (CXL)
CXL is a technique which applies a photosensitizer (Rivoflavin) on the cornea and then it is irradiated with UV light. The goal is to reinforce the chemical bonds of the collagen fibers of the cornea, and therefore increase its strength and rigidity, halting or delaying the progressive irregular changes that appear in keratoconus or corneal ectasia.
Intracorneal Ring Segments (ICRS)
ICRS are small plastic ring segments of different length and thickness that are implanted in the deep layers of the corneal stroma. The effect is to regularize the corneal shape improving visual function, and to increase the rigidity of the cornea avoiding the progression of the ectasia.
Penetrating (PKP) or Lamellar (LKP) Keratoplasty: corneal transplant
In the more advanced cases of keratoconus, the cornea has to be changed by a healthy donor tissue, performing a corneal transplant. In some cases the full thickness of the cornea is exchanged (Penetrating Keratoplasty) and in other cases the deep healthy layers of the cornea are preserved and only the superficial layers are exchanged (Lamellar Keratoplasty).