How to treatment keratoconus ?

Keratoconus; Most of our eyes of the cornea at the front of the hour glass is the name that is similar to the transparent layer.Cornea of the eye is the first optical layer are primarily responsible for the defects. 
Cornea and Keratoconus patients becoming thinner and taking forward a bevel leads to a serious distortion of vision. That's the cornea changes,on average,13-14 years of age continues until the age of 30-35 starts. Keratoconus is a subtype that occurs later in life is Pellucid Marginal degeneration of the disease starting in the mid-20s to 40-50 years continues to progress.

There are two purposes in the treatment of these diseases. 
• Stopping the progression of the disease
• Corneal Collagen Crosslinking
• correction of vision correction
• Specs • contact lenses
• corneal rings
• Corneal collagen croslink accompanied by the excimer laser Corneal Collagen Crosslinking (CXL)

• Keratoplasty: Riboflavin and ultraviolet-A corneal collagen structure weakened by using wavelength reinforcement is based on (Figure 1). Keratoconus is the real and only treatment.Operation;the purpose of the cornea for 30 minutes with 2 minutes with infant drops riboflavin drops the drips, the next 30 minutes is still rivoflavin with drips drops of UV A light reflected in the eye takes an hour for a total of during the operation, although the pain in some patients without complaint.After 3 days it is congested, burning stinging complaints in sight. 
The most important side-effect of treatment is especially thin cornea, corneal endothelial damage, depending on when in the cornea,but in recent years under the limit, especially developed for patients with cornea of hypotonic riboflavin solution with thin cornea in this treatment can be made safely. In this topic, notify your doctor about boundaries. 
The main goal of treatment is to stop the progression of keratoconus and has a good chance of success is close to 0. 60% of the patients disease topographic devolution are being monitored. However, this recovery has always tracked as topographical to see the reflection is not expected. After the treatment the first 1-2 months,it is natural that blur vision. Distribution of the first positive findings are typically 3. monitored and month 6. months after stability is expected. 
In recent years, corneal crosslinking has been treated with rigid contact lenses to the eyes to reduce the patient's excimer controlled laser treatments for addiction. In our clinic since the beginning of 2010 with methods implemented at laser irregularities corrected, thickness is sufficient number of correction applied to the eyes made the results of the treatment of the pipeline is pretty humorous crosslinking.However,these applications are meant to reduce the dependency on hard contact lens, certainly not intended to get rid of the glasses. 

In Summary: • The Main Objective Of the Progress Of Keratoconus Cxl • Increase Seen In Some Patients Is Not Always Predicted Result In Treatment
• After The Procedure The Patient Is Better To Be Able To See The Hard Contact Lenses, Glasses Or Use Tools Such As Targeted. 
• Appropriate Eyes Excimer Laser Treatment After Crosslınkıng Treatment Offers Promising Results In Reducing Addictions Contact Lenses 

Specs: Decreases in Keratoconus and cornea regularity does not usually a good specs for the image.Starting in Keratoconus may be recommended. 

Contact Lens: Keratoconus lenses provide optical regularity by smoothing cornea and Keratoconus patients allows to see the best that can be obtained. Decreases in Keratoconus contact lens patients who can tolerate the most harmless and most effective method is to improve vision.

Intracorneal Rings:Corneal rings cornea correction of optical structure by stretch is based on.These rings are especially developed for the visual of patients for nearsightedness and astigmatism in keratoconus patients for refractive defect is regis is not the greatest chances for success.However early non-corneal thinning decreases in keratoconus, excessive reflection refraction dominated in erection and defect if applicable if non-astigmatism contact lens intolerance in. Excimer laser treatment with the treatment of the with crosslink corneal rings application area contracted. 

Corneal Collagen Crosslinking (CXL) with Excimer Laser;in recent years, the corneal collagen croslink method with excimer laser on successive applications of concentrates.The idea here is the specs of the cornea or hardened with CXL soft contact lens restoring mobility, correcting deformity that prevents seeing 30-40 micron with topography with excimer laser ablation with correcting the patient to recover or hard contact lenses is to prevent the addiction keratoplasty.

Keratoplasty: If the above method fails, all of the occurred on the cornea to treat the cornea is replaced with a cornea. Keratoplasty after cornea usually is not perfect optically, the patient's vision of hard contact lens,excimer needs to be rehabilitated through methods such as laser or glasses. 

All readers; I wish you a healthy and happy life...

Op.Dr.Ahmet UMAY

(Ophtalmology & Podiatric Surgery)

Kaynak : * ) Brıstol Unıversity /UK. Eye’s of Science Clinical ./2012

                *) Özel Tınaztepe Hastanesi / Göz kliniği Neşriyatı.(2015)