Cookies

Like most websites The Ophthalmologist uses cookies. In order to deliver a personalized, responsive service and to improve the site, we remember and store information about how you use it. Learn more.
Subspecialties Cornea/Ocular Surface, Refractive

A Novel Refractive Procedure for Keratoconus

At a Glance

  • A decade ago, keratectasia treatment required heavy-duty surgery
  • Today, most cases can be treated with corneal remodeling techniques in combination with refractive interventions
  • The combination of intracorneal ring segments and phakic IOLs is a viable option for correcting corneal irregularities and large refractive errors in keratoconus patients
  • The choice of technique(s) to use varies by a number of patient factors and the surgeon’s experience

The efficacy of this sequential approach was illustrated by one of my patients who presented with pre-operative best corrected visual acuity (BCVA) of 20/50 and a refraction -8.00 sph -8.00 cyl × 45° in his left eye. I first implanted a 90° 300 µm ICRS and six months later implanted the pIOL. Six months after the second procedure, the patient’s refraction in that eye had improved to +1.00 sph -1.00 cyl × 50° and his BCVA was 20/40 (Figure 2).

The last decade has seen a seismic shift in the treatment of keratectasia and keratoconus. Where spectacles, contact lenses, and penetrating keratoplasty for advanced keratectasia were the only treatment options available, today we have a variety of techniques at our disposal, including corneal crosslinking, intracorneal ring segments (ICRS), topography-guided photoablation, deep anterior lamellar keratoplasty (DALK), and phakic intraocular lenses/implantable collamer lens (pIOLs/ICL). Recently, I have started to combine two of these techniques, ICRS and ICL implantation. I have found that this creates a highly effective refractive intervention for the treatment of patients with keratoconus and high myopia.

Enjoy our FREE content!

Log in or register to read this article in full and gain access to The Ophthalmologist’s entire content archive. It’s FREE and always will be!

Login if you already created an account

Or register now - it’s free and always will be!

You will benefit from:

  • Unlimited access to ALL articles
  • News, interviews & opinions from leading industry experts
  • Receive print (and PDF) copies of The Ophthalmologist magazine
Register

Or Login as a Guest or via Social Media

About the Author

0114-403-ATA-francisco

Francisco Sánchez León

Francisco Sánchez León is the Founder and the Medical and Scientific Director of the Novavisión Laser Center in Naucalpan de Juárez, Mexico, an Assistant Professor at at the New England Eye Center, Tufts University School of Medicine, Boston, MA, USA, and a Consultant at Shingawa Laser Center, Tokyo, Japan. Francisco specialises in refractive and corneal surgery, and also manages the Novavisión Laser Center's Eye Bank.

Register here

Register to access our FREE online portfolio, request the magazine in print and manage your preferences.

You will benefit from:

  • Unlimited access to ALL articles
  • News, interviews & opinions from leading industry experts
  • Receive print (and PDF) copies of The Ophthalmologist magazine

Register