Corneal Ectasia · A Comprehensive Evaluation · Advanced Treatment & Surgery
Comprehensive Keratoconus Treatment
Keratoconus is a progressive condition in which the cornea gradually thins and steepens into an irregular cone, introducing high-order aberrations that glasses and soft lenses cannot fully correct. Early diagnosis and appropriate staging of treatment can halt progression and preserve options for future vision correction.
— Understanding the Disease
What is Keratoconus?
The cornea accounts for approximately two-thirds of the eye's refractive power. Its structural integrity depends on a precisely organised network of collagen fibres within the stroma. In keratoconus, these fibres progressively weaken — allowing the corneal apex to thin and bow forward into an irregular, cone-like shape.
The resulting irregular astigmatism and high-order aberrations distort vision in ways that conventional spectacles cannot neutralise. As disease advances, even rigid gas-permeable and scleral contact lenses may provide diminishing correction. Left untreated, keratoconus may progress to a point where corneal transplantation is the only remaining option.
The condition typically presents in the second or third decade of life. Rate of progression is unpredictable — making early detection and regular topographic monitoring essential for all patients with confirmed or suspected disease.
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Mild — Forme Fruste
Subclinical topographic changes. Vision correctable with spectacles. Monitor closely; CXL if progression documented.
Moderate
Increasing irregular astigmatism. Spectacles inadequate; RGP or scleral lenses needed. CXL to arrest progression.
Mild — Forme Fruste
Significant cone formation. Contact lens tolerance reduced. Reshaping procedures may improve contact lens fit after CXL.
Severe / Hydrops
Dense apical scarring or acute hydrops. May require DALK or PKP if transplant criteria met.
— Spectrum of Treatment
Four Stages of Keratoconus Management
— Halt Progression
Corneal Cross-Linking (CXL)
The only treatment demonstrated to stop Keratoconus from progressing.
Offered in two protocols: epithelium-off (Dresden) and EpiOxa epithelium-on.
Corneal cross-linking stabilize the cornea and preserve all future correction options.
— Advanced Disease
Corneal Transplant Surgery
Surgery to replace a cornea with severely diseased keratoconus, with a new, healthy, clear cornea. Primary techniques are Deep Anterior Lamellar Keratoplasty (DALK) and Penetrating Keratoplasty (PKP).
The entire corneal stroma is removed and replaced with this surgery.
— Improve Corneal Shape
Corneal Reshaping
For patients with irregular astigmatism after corneal stabilization with CXL.
Options include:
—> CAIRS Customized Corneal Allogenic Intrastromal Ring Segments,
—> Combined Topography-Guided PRK with CXL (Athens Protocol or TOPOLink Protocol).
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— Coexisting Cataract
Cataract Surgery with Keratoconus
Specialized biometry, IOL selection, and surgical planning are required in eyes with keratoconus. The Apthera IC8 Small Aperture IOL is a well-suited option, providing an extended depth of focus less dependent on centration in an irregular cornea.
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— Keratoconus
Comprehensive Keratoconus Management
& a personalized treatment plan
A keratoconus evaluation with Dr. Hu includes corneal topography with Scheimpflug imaging, wavefront analysis, and pachymetry — followed by an honest discussion of where you are in the disease spectrum and which treatment options are appropriate.