Centre for Keratoconus in London Specialist in Diagnosis and Treatment

What is Keratoconus?

Keratoconus is a long-term eye condition where the cornea, the clear front part of the eye, changes shape. Instead of being round, it becomes cone-shaped, making vision blurry and distorted. This condition can get worse over time, and in severe cases, the back of the cornea might tear, leading to a problem called Acute Corneal Hydrops (ACH) and form scar.

Who is at risk of having Keratoconus?

Keratoconus usually shows up between ages 10 and 25. It can be linked to other conditions like allergies, asthma, eczema, and sometimes genetic disorders like Down's Syndrome. It's an inherited condition affecting about 1 in 3,000 people, with higher rates in Asians (1 in 500) compared to Caucasians (1 in 2000). Both men and women are equally affected, and the condition is often more severe in one eye than the other.

What are the signs and symptoms?

The main symptom is blurry vision caused by the cornea bulging forward, which can be confused with regular nearsightedness or astigmatism. In the early stages, glasses or contact lenses can correct vision, but as the cornea becomes more irregular, rigid contact lenses may be needed. Regular eye exams are important to ensure contact lenses fit well to avoid corneal damage. Most cases stabilise by age 35, but in about 15% of people, the condition worsens, possibly requiring a corneal transplant.

Can Keratoconus be prevented?

Most cases can't be prevented, but protecting your eyes from UV light with sunglasses and ensuring contact lenses fit well can help.

What treatments are available?

1. Corneal Collagen Crosslinking (CXL)

CXL is a treatment designed to strengthen the cornea and halt the progression of keratoconus. There are two main types of CXL procedures:

a. Traditional CXL:

• Procedure: The top layer of the cornea (epithelium) is removed to allow riboflavin (vitamin B2) drops to penetrate. After the cornea is soaked with riboflavin, UV light is shone onto the cornea for about 30 minutes.
• Effectiveness: This treatment increases the number of collagen crosslinks, which strengthens the cornea and stabilises its shape.
• Recovery: A bandage contact lens is placed on the eye post-procedure, with healing taking about 3 to 5 days.

b. Accelerated CXL :

• Procedure: Similar to traditional CXL, but the UV light exposure time is reduced, completing the treatment in a few minutes.
• Effectiveness: Provides the same benefits as traditional CXL but in a shorter duration.
• Recovery: Similar to traditional CXL, with a bandage contact lens used and healing taking a few days.

2. TransPRK/CXL (Crosslinking Plus)

This is a combination of CXL with a laser vision correction procedure called TransPRK (transepithelial photorefractive keratectomy).

• Procedure: The top layer of the cornea is removed using a laser, which reshapes the superficial layers of the cornea. This reshaping corrects the irregularities caused by keratoconus. After the laser treatment, CXL is performed to strengthen the cornea.
• Effectiveness: This combined approach not only halts the progression of keratoconus but also improves vision by correcting the shape of the cornea.
• Recovery: Takes about 20 minutes per eye, with recovery involving some discomfort and a healing period of several days.

3. Intra Corneal Ring Segments (ICRS)

ICRS are small, arc-shaped plastic inserts placed within the cornea to flatten and reshape it.

• Procedure: A laser is used to create channels in the cornea where the rings are inserted. These rings help flatten the central part of the cornea, improving its shape and reducing vision distortion.
• Effectiveness: Provides a significant improvement in vision for many patients, particularly those with moderate to severe keratoconus.
• Recovery: The procedure is relatively low risk with a quick recovery time. However, the degree of vision improvement can vary.

4. Xenia Implants

Xenia implants are used to strengthen and stabilise the cornea, potentially delaying or avoiding the need for a corneal transplant.

• Procedure: These implants are made from cross-linked material, which is stronger than the patient’s corneal tissue. They are inserted without stitches, reducing complications.
• Effectiveness: The implants help regularise the corneal shape and improve vision, while also increasing corneal thickness.
• Recovery: Faster visual recovery and fewer follow-up visits due to the sutureless procedure.

5. Corneal Allogenic Intra stromal Ring Segments (CAIRS)

CAIRS use donor corneal tissue instead of synthetic materials for the ring segments.

• Procedure: A ring of corneal tissue from a donor is placed into channels created in the patient’s cornea with a laser.
• Effectiveness: Biocompatible with fewer risks of complications compared to synthetic implants. The procedure offers better stability and can be used for patients with more severe keratoconus.
• Recovery: Quick recovery time with a higher degree of customisation to fit the patient’s needs.

6. Corneal Inlays (Keratophakia)

Corneal inlays are implants placed in the corneal stroma to correct vision problems like presbyopia.

• Procedure: These disc-shaped implants are inserted into the cornea, either under a flap or in a pocket, to change the cornea’s curvature.
• Effectiveness: They improve near vision by adjusting the refractive index of the cornea, functioning similarly to multifocal contact lenses.
• Recovery: Generally involves a short recovery period with gradual improvement in vision.

7. Corneal Transplant (Keratoplasty)

In cases where other treatments fail, a corneal transplant may be necessary.

a. Penetrating Keratoplasty (PK):

• Procedure: The damaged cornea is completely removed and replaced with a full-thickness donor cornea.
• Effectiveness: High success rate, though patients will still need corrective lenses.
• Recovery: Long recovery time, with the risk of complications like graft rejection.

b. Deep Anterior Lamellar Keratoplasty (DALK):

• Procedure: Only the outer layers of the cornea are replaced, preserving the patient’s inner corneal layers.
• Effectiveness: Lower risk of rejection compared to PK, but technically more challenging.
• Recovery: Faster recovery time with fewer complications.

These treatments offer various options to manage keratoconus, each with its benefits and considerations depending on the severity and progression of the condition. Regular consultations with an eye specialist are crucial to determine the most suitable treatment plan.

Reason to Choose us for Treating Keratoconus in London

Excellent experts

Our surgeons have received the best training at the best centres in London and around the world.

We're a consultant-led clinic

Patients get customised treatment plans for specific needs, followed by great care and support after treatment.

State-of-the-art technology

Laser eye surgery and lens surgery are done using the latest technology and tools in the industry.

Easy access

You can visit our central clinic in London for eye treatment.

Video consultation

Should it not be possible for you to come in person to our clinic, you can get our professional help via video consultation. This is available for both patients who are insured and paying from their pocket.

Zero percent financing***

We offer a 0% finance*** for patients who need any of our eye surgical treatments. With this, you can pay more conveniently by spreading payment over some months if required.

Are you having problems with eyesight and would like a diagnostic test and possible treatment options, feel free to contact us today.