We have various options depending on your unique case. These include:
- Customised contact lenses
- Corneal rings/implants (intracorneal rings/segments or corneal inlays)
- Intraocular lens implantation
- Various types of corneal transplantation
- Topoguided laser vision correction
We are one of the very few centres in the world to perform a combination of various treatments.
The principle is to give you a complete treatment package of therapies that will strengthen your cornea and stabilise your keratoconus and at the same time, correct your vision.
Corneal cross-linking (CXL)
Corneal cross-linking a surgical procedure aimed at:
- Patients with keratoconus, which is a congenital corneal disease. It starts in early childhood and progresses quickly to result in distortion of the standard corneal shape and curvature
- Patients with corneal ectasia which is very similar to keratoconus but occurs after corneal refractive surgery such as LASIK, LASEK or SMILE where the cornea has become very weak
What does the procedure involve?
I apply one drop of riboflavin on the eye every 5 minutes for 30 minutes, and then the cornea is illuminated with UV-A light for approx.10 – 30 minutes (depending on the cross-linker used). The riboflavin forms bonds on the stromal layer of the cornea. We cover the eye with a bandage contact lens which is removed 5 to 7 days after the procedure. The cornea will be examined and scanned at frequent intervals to monitor for its stability.
I occasionally offer other types of cornea cross linking like Epi-on CXL. This is where we loosen your epithelium with eye drops or a sponge before putting in the eyedrops.
Corneal ring implants (Intracorneal Ring Segments ICRS)
Corneal implants are crescent-shaped rings that we place in the periphery of the cornea. They affect refraction in the eye by physically changing the shape of the cornea, flattening the front of the eye, and so correcting the irregular corneal shape.
What does the procedure involve?
We undertake the procedure under local anaesthesia. We make an incision in the cornea and create channels in it by using a femtosecond laser to ensure high precision. We then introduce one to two corneal implant segments is introduced into the channel. We offer various implants with a range of implant thicknesses for different degrees of correction.
Corneal rings are designed to remain permanently in the eye, yet we can also remove or replace them if needed.
With early detection, corneal cross linking with or without corneal rings implants will be sufficient to control keratoconus. However, if the disease is aggressive, progressive, or advanced then corneal transplant (corneal grafting) will be the only solution. In the most majority of keratoconus cases, partial thickness corneal transplant which is called Deep Anterior Lamellar Keratoplasty (DALK) would be sufficient. But if there is damage to the lining of the cornea then we can perform full-thickness corneal graft. Once the corneal graft is taken well and is stable then i could discuss with you various methods to improve the vision further. For example, you could benefit from laser / phototherapeutic keratoplasty (PTK), or topography-guided laser refractive surgery, or some type of intraocular lens implants such as Implantable contact / collamer lenses (ICL).