Experience in Treatment of Patients with Keratoconus and Keratectasia
The aim of the investigation was to analyze experimental and clinical functional results of treatment of patients with keratoconus and secondary keratectasia using modern techniques.
Materials and Methods. We carried out experimental researches on 15 eyes of experimental animals. The animals underwent corneal cross-linking according to Zurich protocol. We used laser radiation of 0.37 J. Further, on day 3 to 10, the animals were sacrificed, and we performed light and electron microscopy of the operated corneas.
Clinical functional study was carried out on 108 eyes of 54 patients with primary keratoconus and secondary keratectasia.
Conclusion. The findings suggest the following approach to treatment of patients with primary keratoconus and surgery-induced keratectasias:
1) patients with I and II stages of primary keratoconus and stages I–III keratectasias — personalized cross-linking, and no earlier than 4 months later — implantation of intracorneal implants; after surgery — correction by soft contact lenses;
2) stage III keratoconus patients — cross-linking according to Zurich protocol, with no guarantee of significant improvement of acuity of vision — implantation of stromal rings in 4 months; correction by soft contact lenses. A patient is to be warned of possible keratoplasty;
3) in complicated III–IV stage keratoconus and secondary ectasia — planned penetrating keratoplasty.
- Stephen Tuft. Epidemiology of keratoconus. In: EuroKeratoConus II congress. Abstracts. France; 2011; p. 84–86.
- Caporossi А., Baiocchi S., Mazzotta C., Traversi C., Caporossi T. Parasurgical therapy for keratoconus by riboflavin-ultraviolet type A rays induced cross-linking of corneal collagen: preliminary refractive results in an Italian study. J Cataract Refract Surg 2006 May; 32(5): 837–845.
- Michael Belin. Role of corneal tomography and biomechanics for diagnosis, prognosis and treatment planning of ectatic diseases. In: EuroKeratoConus II congress. Abstracts. France; 2011; p. 35–37.
- Egorova G.B. Kontaktnaya korrektsiya keratokonusa i otsenka ee effektivnosti [Contact correction of keratoconus and its efficiency assessment]. Vestnik optometrii — Optometry Reporter 2004; 2: 31–33.
- Murova L.Kh. Korrektsiya keratokonusa zhestkimi kontaktnymi linzami. Avtoref. dis. … kand. med. nauk [Keratoconus correction by rigid contact lenses. Abstract for Dissertation for the degree of Candidate of Medical Science]. Ufa; 2005.
- Wollensak G., Spoerl E., Wilsch M., Seiler T. Keratocyte apoptosis after corneal collagen cross-linking using riboflavin/UVA treatment. Cornea 2004 Jan; 23(1): 43–49.
- Spoerl E., Wollensak G., Seiler T. Increased resistance of crosslinked cornea against enzymatic digestion. Curr Eye Ress 2004 Jul; 29(1): 35–40.
- Seiler T. Corneal cross-linking-induced stromal demarcation line. Cornea 2006 Oct; 25(9): 1057–1059.
- Jorge Alio. Refractive surgery in the keratoconic patients. In: EuroKeratoConus II. Congress. Abstracts. France; 2011.
- Gorskova E.N., Sevost'yanov E.N. Vizual'nye iskhody skvoznoy keratoplastiki u bol'nykh keratokonusom na raznykh stadiyakh zabolevaniya [Visual outcomes of penetrating keratoplasty in patients with keratoconus at various stages of the disease]. Glaz — Eye 1998; 3: 6–11.
- Kasparova E.A. Osobennosti postoperatsionnoy terapii u patsientov, perenesshikh skvoznuyu keratoplastiku po povodu keratokonusa. V kn.: Aktual'nye voprosy oftal'mologii. Materialy yubil. vseros. konf., posvyashch. 100-letiyu gorodskoy glaznoy bol'nitsy im. Alekseevykh [Characteristics of postoperative therapy in patients after penetrating keratoplasty for keratoconuc. In: Topical ophthalmological issues. Proceedings of jubilee all-Russian conference on centenary of city eye hospital named after V.A. and A.A. Alekseev]. Moscow: NII glaznykh bolezney im. Gel’mgol’tsa; 2002; Part 2; p. 17–20.
