Keratoconus is an eye condition wherein an individual’s normally round cornea thins over time and progressively becomes cone shaped. Keratoconus is non-infectious, and is caused by the weakening of collagen fibers in the eye that help to hold and maintain the shape of the cornea. This irregularity causes images to be distorted when projected onto the retina, resulting in significant visual impairment.
Keratoconus often affects both eyes of those afflicted, although the progress of keratoconus is often more rapid in one eye over the other. The incidence of Keratoconus has been reported to affect approximately 1 in every 2,000 individuals; it is often diagnosed in the late teens. Males, females, and all ethnicity's are affected equally.
In the early stages of Keratoconus, glasses or soft contact lenses may be used for adequate vision correction. However, as the cornea progressively thins and bulges into a more cone-like shape, rigid gas permeable (RGP) lenses are often necessary. Gas permeable lenses are the most highly effective way to manage keratoconus, and 90% of all cases can be managed this way indefinitely by providing a regular surface over the cornea that is able to neutralize distortions. RGP lenses have tremendously changed in the last several years. With improved optics, improved comfort, and increased breathability, RGP contacts have become a very successful means to aid in visual improvement and stability.
RGP lenses were once considered the only treatment option for Keratoconus, but in recent years, new methods have been developed to manage the disorder. Corneal Cross-Linking is a procedure used to slow or stop the progression of Keratoconus by strengthening the bonds that maintain the shape of the cornea. Although it does not cure Keratoconus, this procedure works to halt its progression and prevent the cornea from advancing in its irregularity. Although this procedure is not yet FDA approved in the United States, it is occasionally performed as part of an FDA-trial or under off-label status, which means at the surgeon’s discretion or with the full consent of the patient.
Intacs®, or intrastromal corneal ring segments (ICRS), are used to reshape and normalize the cornea without removing corneal tissue, allowing for contact lenses to better fit the eye. Intacs® are thin inserts that are placed into a channel in the outer edge of the cornea, created by a femtosecond laser. Intacs® corneal implants are intended for the reduction or elimination of myopia and astigmatism in patients with Keratoconus when contact lenses or glasses fail to provide adequate vision correction. The goal of Intacs inserts is to restore functional vision and potentially defer the need for a corneal transplant procedure.