Current methods in the treatment of keratoconus

Abstract

Keratoconus is a bilateral, asymmetrical, non-inflammatory, and progressive thinning disease of the cornea. The etiology and pathogenesis of the disease are not known exactly. However, significant advances have been achieved in the treatment of keratoconus in the recent years. In the past, penetrating keratoplasty was the only treatment option in advanced keratoconus. Nowadays, therapeutic advances for keratoconus have been provided various treatment options in different stages of the disease and opportunity to stop the progression of the disease, to rehabilitate vision, or to achieve both. This review analyzes the current methods in the treatment of keratoconus, such as new contact lens designs, corneal collagen cross-linking, intracorneal rings, deep anterior lamellar keratoplasty, conductive keratoplasty, intraocular refractive lenses, photorefractive keratectomy, and combinations of these.

Keywords

• Keratoconus, Contact lenses, Collagen crosslinking, Intracorneal rings, Lameller keratoplasty

Keratokonus tedavisinde güncel yöntemler

Abstract

Keratokonus, korneanın bilateral, asimetrik, enflamatuar olmayan ve ilerleyici incelme ile seyreden bir hastalığıdır. Hastalığın etyolojisi ve patogenezi tam olarak bilinmemektedir. Ancak, son yıllarda keratokonus tedavisinde önemli gelişmeler elde edilmiştir. Geçmişte, ilerlemiş keratokonusta penetran keratoplasti tek tedavi seçeneği idi. Günümüzde, keratokonus için tedavi edici gelişmeler hastalığın farklı aşamalarında çeşitli tedavi seçenekleri sağlamaktadır ve hastalığın ilerlemesini durdurmak, vizyon rehabilitasyonu veya her ikisini birden elde etme fırsatı vermektedir. Bu derleme, keratokonus tedavisinde yeni kontakt lens modelleri, korneal kollajen çapraz bağ, kornea içi halkalar, derin ön lameller keratoplasti, konduktiv keratoplasti, göz içi refraktif lensler, fotorefraktif keratektomi ve bu yöntemlerin kombinasyonu gibi güncel yöntemleri analiz etmektedir.

Keywords

• Keratokonus, Kontakt lensler, Kolla

References

1. Rabinowitz YS. Keratoconus. Surv Ophthalmol 1998; 42: 297-3
2. Barnett M, Mannis MJ. Contact lenses in the management of keratoconus. Cornea 2011; 30: 1510-1516.
3. Gonzalez-Meijome JM, Jorge J, de Almeida JB, Parafita MA. Soft contact lenses for keratoconus: Case report. Eye Contact Lens 2006; 32: 143-147.
4. Edrington TB, Szczotka LB, Barr JT, Achtenberg JF, Burg- er DS, Janoff AM, Olafsson HE, Chun MW, Boyle JW, Gor- don MO, Zadnik K. Rigid contact lens fitting relationships in keratoconus. Optom Vis Sci 1999; 76: 692-699.
5. Edrington TB, Gundel RE, Libassi DP, Wagner H, Pierce GE, Walline JJ, Barr JT, Olafsson HE, Steger-May K, Acht- enberg J, Wilson BS, Gordon MO, Zadnik K; CLEK STUDY GROUP. Variables affecting rigid contact lens comfort in the collaborative longitudinal evaluation of keratoconus (CLEK) study. Optom Vis Sci 2004; 81: 182-188.
6. Betts AM, Mitchell GL, Zadnik K. Visual performance and comfort with the Rose K lens for keratoconus. Optom Vis Sci 2002; 79: 493-501.
7. Jain AK, Sukhija J. Rose-K contact lens for keratoconus. Indian J Ophthalmol 2007; 55: 121-125.
8. Rathi VM1, Mandathara PS, Dumpati S. Contact lens in keratoconus. Indian J Ophthalmol 2013; 61: 410-415.

9. Mandathara Sudharman P, Rathi V, Dumapati S. Rose K lenses for keratoconus-An Indian experience. Eye Contact Lens 2010; 36: 220-222.
10. Gunes A, Kubaloglu A, Bayramlar H. Rose K Lenses for Keratoconus. Turk J Ophthalmol 2012; 42: 88-90.
11. Ozbek Z, Cohen EJ. Use of intralimbal rigid gas-perme- able lenses for pellucid marginal degeneration, keratoconus, and after penetrating keratoplasty. Eye Contact Lens 2006; 32: 33-36.
12. Sengor T, Kurna SA, Aki S, Ozkurt Y. High Dk piggyback contact lens system for contact lens-intolerant keratoconus patients. Clin Ophthalmol 2011; 5: 331-335.
13. Abdalla YF, Elsahn AF, Hammersmith KM, Cohen EJ. SynergEyes lenses for keratoconus. Cornea 2010; 29: 5-8.
14. Fernandez-Velazquez FJ. Severe epithelial edema in Clearkone SynergEyes contact lens wear for keratoconus. Eye Contact Lens 2011; 37: 381-385.
15. Schornack MM, Patel SV. Scleral lenses in the manage- ment of keratoconus. Eye Contact Lens 2010; 36: 39-44.
16. Spoerl E, Huhle M, Seiler T. Induction of cross-links in corneal tissue. Exp Eye Res 1998; 66: 97-103.
17. Wollensak G, Spoerl E, Seiler T. Riboflavin/ ultravio- let-A-induced collagen crosslinking for the treatment of kera- toconus. Am J Ophthalmol 2003; 135: 62-627.
18. Caporossi A, Mazzotta C, Baiocchi S, Caporossi T. Long-term results of riboflavin ultraviolet a corneal collagen cross-linking for keratoconus in Italy: the Siena eye cross study. Am J Ophthalmol 2010; 149: 585-593.
19. Kanellopoulos AJ, Asimellis G. Keratoconus manage- ment: long-term stability of topography-guided normalization combined with high-fluence CXL stabilization (the Athens Protocol). J Refract Surg 2014; 30: 88-93.
20. Goldich Y, Barkana Y, Wussuku Lior O, Marcovich AL, Hirsh A, Avni I, Zadok D. Corneal collagen cross-linking for the treatment of progressive keratoconus: 3-year prospective outcome. Can J Ophthalmol 2014; 49: 54-59.
21. Schumacher S, Oeftiger L, Mrochen M. Equivalence of biomechanical changes induced by rapid and standard corneal crosslinking, using riboflavin and ultraviolet radiation. Invest Ophthalmol Vis Sci 2011; 52: 9048-9052.
22. Kanellopoulos AJ. Long term results of a prospective randomized bilateral eye comparison trial of higher fluence, shorter duration ultraviolet A radiation, and riboflavin colla- gen cross linking for progressive keratoconus. Clin Ophthal- mol 2012; 6: 97-101.
23. Kanellopoulos AJ. Long term results of a prospective randomized bilateral eye comparison trial of higher fluence, shorter duration ultraviolet A radiation, and riboflavin colla- gen cross linking for progressive keratoconus. Clin Ophthal- mol 2012; 6: 97-101.
24. Cınar Y, Cingü AK, Türkcü FM, Cınar T, Yüksel H, Oz- kurt ZG, Caça I. Comparison of accelerated and conventional corneal collagen cross-linking for progressive keratoconus. Cutan Ocul Toxicol 2013 Oct 22. doi:10.3109/15569527.20 834497. [Epub ahead of print]
25. Ertan A, Colin J. Intracorneal rings for keratoconus and keratectasia. J Cataract Refract Surg 2007; 33: 1303-1314.
26. Pinero DP, Alio JL. Intracorneal ring segments in ectat- ic corneal disease - A review. Clin Experiment Ophthalmol 2010; 38: 154-167.
27. Zare MA, Hashemi H, Salari MR. Intracorneal ring seg- ment implantation for the management of keratoconus: Safety and efficacy. J Cataract Refract Surg 2007; 33: 1886-1891.
28. Kubaloglu A, Sari ES, Cinar Y, Koytak A, Kurnaz E, Oz- ertürk Y. Intrastromal corneal ring segment implantation for the treatment of keratoconus. Cornea 2011; 30: 11-17.
29. Sinjab MM. Quick guide to the management of keratoco- nus. A systematic step-by-step approach. Dordrecht; Spring- er-Verlag Berlin Heidelberg; 2012: 59-93.
30. Vega-Estrada A, Alio JL, Brenner LF, Javaloy J, Plaza Puche AB, Barraquer RI, Teus MA, Murta J, Henriques J, Uceda-Montanes A. Outcome analysis of intracorneal ring segments for the treatment of keratoconus based on visual, refractive, and aberrometric impairment. Am J Ophthalmol 2013; 155: 575-584.
31. Fukuoka S, Honda N, Ono K, Mimura T, Usui T, Amano S. Extended long-term results of penetrating keratoplasty for keratoconus. Cornea 2010; 29: 528-530.
32. Pramanik S, Musch DC, Sutphin JE, Farjo AA. Extended long-term outcomes of penetrating keratoplasty for keratoco- nus. Ophthalmology 2006; 113: 1633-1638.
33. Jensen LB, Hjortdal J, Ehlers N. Longterm follow-up of penetrating keratoplasty for keratoconus. Acta Ophthalmol 2010; 88: 347-351.
34. Melles GR, Lander F, Rietveld FJ, Remeijer L, Beekhuis WH, Binder PS. A new surgical technique for deep stromal, anterior lamellar keratoplasty. Br J Ophthalmol 1999; 83: 327-3
35. Anwar M, Teichmann KD. Big-bubble technique to bare Descemet’s membrane in anterior lamellar keratoplasty. J Cataract Refract Surg 2002; 28: 398-403.
36. Steven P, Le Blanc C, Lankenau E, Krug M, Oelckers S, Heindl LM, Gehlsen U, Huettmann G, Cursiefen C. Op- timising deep anterior lamellar keratoplasty (DALK) using intraoperative online optical coherence tomography (iOCT). Br J Ophthalmol 2014 Mar 3. doi: 10.1136/bjophthal- mol-2013-304585. [Epub ahead of print]
37. Bahar I, Kaiserman I, Srinivasan S, Ya-Ping J, Slomovic AR, Rootman DS. Comparison of three different techniques of corneal transplantation for keratoconus. Am J Ophthalmol 2008; 146: 905-912.
38. Watson SL, Ramsay A, Dart JK, Bunce C, Craig E. Com- parison of deep lamellar keratoplasty and penetrating kera- toplasty in patients with keratoconus. Ophthalmology 2004; 111: 1676-1682.
39. Kim KH, Choi SH, Ahn K, Chung ES, Chung TY. Com- parison of refractive changes after deep anterior lamellar ker- atoplasty and penetrating keratoplasty for keratoconus. Jpn J Ophthalmol 2011; 55: 93-97.
40. Funnell CL, Ball J, Noble BA. Comparative cohort study of the outcomes of deep lamellar keratoplasty and penetrating keratoplasty for keratoconus. Eye (Lond) 2006; 20: 527-532.
41. Reinhart WJ, Musch DC, Jacobs DS, Lee WB, Kaufman SC, Shtein RM. Deep anterior lamellar keratoplasty as an al- ternative to penetrating keratoplasty: a report by the Ameri- can Academy of Ophthalmology. Ophthalmology 2011; 118: 209-2
42. Asbell PA, Maloney RK, Davidorf J, Hersh P, McDonald M, Manche E; Conductive Keratoplasty Study Group. Con- ductive keratoplasty for the correction of hyperopia. Trans Am Ophthalmol Soc 2001; 99: 79-84.
43. McDonald MB, Durrie D, Asbell P, Maloney R, Nichamin L. Treatment of presbyopia with conductive keratoplasty: six- month results of the 1-year United States FDA clinical trial. Cornea 2004; 23: 661-668.
44. Alió JL, Claramonte PJ, Cáliz A, Ramzy MI. Corneal modeling of keratoconus by conductive keratoplasty. J Cata- ract Refract Surg 2005; 31: 190-197.
45. Lyra JM, Trindade FC, Lyra D, Bezerra A. Outcomes of radiofrequency in advanced keratoconus. J Cataract Refract Surg 2007; 33: 1288-1295.
46. Kato N, Toda I, Kawakita T, Sakai C, Tsubota K. Topogra- phy-guided conductive keratoplasty: treatment for advanced keratoconus. Am J Ophthalmol. 2010; 150: 481-489.
47. Ormonde S. Refractive surgery for keratoconus. Clin Exp Optom 2013; 96: 173-182.
48. Tahzib NG, Nuijts RM, Wu WY, Budo CJ. Longterm study of Artisan phakic intraocular lens implantation for the correction of moderate to high myopia: ten-year follow-up re- sults. Ophthalmology 2007; 114: 1133-1142.
49. Landesz M, Worst JG, van Rij G. Long-term results of correction of high myopia with an iris claw phakic intraocular lens. J Refract Surg 2000; 16: 310-316.
50. Menezo JL, Peris-Martinez C, Cisneros AL, Marti- nez-Costa R. Phakic intraocular lenses to correct high my- opia: Adatomed, Staar, and Artisan. J Cataract Refract Surg 2004; 30: 33-44.
51. Budo C, Bartels MC, van Rij G. Implantation of Artisan toric phakic intraocular lenses for the correction of astigma- tism and spherical errors in patients with keratoconus. J Re- fract Surg 2005; 21: 218-222.
52. Venter J. Artisan phakic intraocular lens in patients with keratoconus. J Refract Surg 2009; 25: 759-764.
53. Sedaghat M, Ansari-Astaneh MR, Zarei-Ghanavati M, Davis SW, Sikder S. Artisan iris-supported phakic IOL im- plantation in patients with keratoconus: a review of 16 eyes. J Refract Surg 2011; 27: 489-493.
54. Kato N, Toda I, Hori-Komai Y, Sakai C, Arai H, Tsubota K. Phakic intraocular lens for keratoconus. Ophthalmology 2011; 118: 605.
55. Moshirfar M, Gregoire FJ, Mirzaian G, Whitehead GF, Kang PC. Use of Verisyse iris-supported phakic intraocular lens for myopia in keratoconic patients. J Cataract Refract Surg 2006; 32: 1227-1232.
56. Kasparova EA, Kasparov AA. Six-year experience with excimer laser surgery for primary keratoconus in Russia. J Refract Surg 2003; 19 (Suppl): 250-254.
57. Chelala E, Rami HE, Dirani A, Fadlallah A, Fakhoury O, Warrak E. Photorefractive keratectomy in patients with mild to moderate stable keratoconus: a five-year prospective fol- low-up study. Clin Ophthalmol 2013; 7: 1923-1928.
58. Kanellopoulos AJ. Comparison of sequential vs same-day simultaneous collagen cross-linking and topography-guided PRK for treatment of keratoconus. J Refract Surg 2009; 25: 812-8
59. Dirani A, Fadlallah A, Syed ZA, Chelala E, Khoueir Z, Cherfan G, Jarade E. Non-topography-guided photorefractive keratectomy for the correction of residual mild refractive er- rors after ICRS implantation and CXL in keratoconus. J Re- fract Surg 2014; 30: 266-271.
60. Severinsky B, Wajnsztajn D, Frucht-Pery J. Silicone hy- drogel mini-scleral contact lenses in early stage after corneal collagen cross-linking for keratoconus: a retrospective case series. Clin Exp Optom 2013; 96: 542-546.
61. Moreira LB, Bardal RA, Crisigiovanni LR. Contact lenses fitting after intracorneal ring segments implantation in kerato- conus. Arq Bras Oftalmol 2013; 76: 215-217.
62. Severinsky B, Behrman S, Frucht-Pery J, Solomon A. Scleral contact lenses for visual rehabilitation after penetrat- ing keratoplasty: Long term outcomes. Cont Lens Anterior Eye 2014; 37: 196-202.
63. Shafik Shaheen M1, El-Kateb M, El-Samadouny MA, Zaghloul H. Evaluation of a toric implantable collamer lens after corneal collagen crosslinking in treatment of early-stage keratoconus: 3-year follow-up. Cornea 2014; 33: 475-480.
64. Coskunseven E, Onder M, Kymionis GD, Diakonis VF, Arslan E, Tsiklis N, Bouzoukis DI, Pallikaris I. Combined Intacs and posterior chamber toric implantable collamer lens implantation for keratoconic patients with extreme myopia. Am J Ophthalmol 2007; 144: 387-389.
65. Al-Tuwairqi W, Sinjab MM. Intracorneal ring segments implantation followed by same-day topography-guided PRK and corneal collagen CXL in low to moderate keratoconus. J Refract Surg 2013; 29: 59-63.