Overcoming Keratoconus: Treatment Breakthroughs and Latest Updates

In its normal state, the cornea is a clear, dome-shaped structure that is smooth and symmetrical. This allows it to focus light that enters the eye, enabling clear vision.

However, with keratoconus, the cornea becomes distorted, causing blurred vision and increased sensitivity to light, among other symptoms. This progressive eye condition causes the cornea to thin and changes it from a dome to a conical shape.

A study shows it is highly prevalent in the United Arab Emirates, particularly among adolescents. Fortunately, this degenerative eye condition can be caught early to help prevent further complications, like vision loss.

In this blog, we’ll discuss all the keratoconus treatment breakthroughs and the latest updates on managing the condition.

Glasses and Lenses

Early-stage keratoconus can be managed with prescription glasses and contact lenses. These not only correct the cornea’s curvature but also help improve eyesight.

People with keratoconus must have their glasses and lenses replaced as frequently as their corneas change shape. The options available include:

• Soft contact lenses – ideal for the early stages.
• Hard contact lenses – may be required as the keratoconus advances.
• Piggyback contact lenses – using a hard lens on top of a soft one; an alternative to hard contact lenses.
• Hybrid contact lenses – comes with a soft skirt around the ring and rigid center for a more comfortable fit; another alternative to hard lenses.
• Scleral contact lenses – lenses that rest on top of the white part of the eye; ideal for corneas with highly irregular shapes, like those with advanced keratoconus.

Before choosing a contact lens, consult an ophthalmologist to determine the best keratoconus treatment in Dubai for you.

Corneal Cross-Linking Surgery

When lenses and prescription glasses can no longer manage keratoconus, your eye doctor may recommend corneal cross-linking surgery.

This method entails saturating the cornea with riboflavin (a type of vitamin B) eye drops and exposing it to ultraviolet (UV) light. This activates the riboflavin, causing a cross-linking effect that stiffens the cornea and halts further thinning, distortion, and scarring.

Corneal cross-linking stabilises the cornea’s structure. It can decrease corneal bulging, enabling better vision with contact lenses and glasses. This treatment can also potentially prevent the need for a cornea transplant.

Over the years, scientists have worked to improve this keratoconus treatment, reducing discomfort and the length of time needed for the procedure.

A new breakthrough improved the original protocol (the Dresden method) to lower the UV radiation exposure needed for cross-linking from 30 minutes to nine to 15 minutes.

Moreover, recent advances enabled eye surgeons to keep the epithelium intact (epi-on) to lower the risk of infection and discomfort among patients.

Corneal Transplants

For patients with extremely thin corneas and advanced scarring, eye specialists may recommend corneal transplants, also known as keratoplasty.

Depending on the case’s complexity, an eye doctor may recommend complete or partial replacement of the cornea from a healthy donor tissue.

Intrastromal Ring Inserts

Patients with mild to moderate keratoconus can also undergo a procedure that inserts small synthetic rings into the cornea, called Intacs©.

Approved by the Food and Drug Administration (FDA), Intacs© rings help adjust the shape of the cornea and improve its structural integrity. These small semicircular plastic rings are placed in the mid- to outer edges of the cornea to create a flatter central area and correct myopic refractive error.

These intrastromal corneal ring segments (ICRS) can also be used with other keratoconus treatments, such as contact lenses and corneal cross-linking.

Stem Cell Therapy

Keratoconus is partly caused by the loss of keratocytes (corneal cells) and the breakdown of collagen fibres. To address this, researchers are exploring cell therapy to regenerate the cornea.

This involves injecting healthy corneal cells into the damaged cornea. These cells can come from stem cells or other sources, such as fat tissue, umbilical cord blood, or dental pulp (the soft tissue at the centre of a tooth).

Cell therapy aims to slow the progression of keratoconus and restore the cornea’s structure. While further studies need to be conducted, a review of cell therapy for keratoconus concluded that this is a promising development in keratoconus treatment.

Biosynthetic Transplants

Finding a healthy donor for a corneal transplant can be challenging. To remedy this, scientists are developing biosynthetic corneas as an alternative to donor tissue.

Biosynthetic corneas are made from recombinant human collagen type III (RHCIII), which is designed to mimic natural corneal tissue. Research has shown that these biosynthetic corneas can integrate well with the eye, promote tissue regeneration, and restore corneal function.

Improvements to these implants are underway with new versions, such as a liquid form that gels inside the eye, offering a low-cost, immune-compatible option to address the shortage of donor corneas.

A Final Word

“What is the best treatment for keratoconus?” The answer depends on the specific case. Fortunately, more and more options are emerging, making keratoconus management more accessible than ever.

While there is no known cure for keratoconus, treatment options are advancing steadily for the better. Consult your trusted eye specialist at Gulf Family Clinic to get the best keratoconus treatment in Dubai that is specifically for you.