Keratoconus is a genetic progressive disease of the cornea. Without treatment, it can lead to a significant decrease in visual acuity or complete blindness.

Corneal Collagen Cross Linking

One of the most promising areas in the treatment of keratoconus is ultraviolet cross-linking, which strengthens and stabilizes the cornea by creating new links between collagen fibers within the cornea. This effect is achieved by photopolymerization of its stromal fibers under the combined influence of a photosensitizer and ultraviolet light with a wavelength of 365 nm. This treatment is minimally invasive and local anaesthetic drops are instilled so that the procedure is not painful. Riboflavin drops are instilled frequently while ultraviolet light is applied directly onto the cornea for 30 minutes. This treatment strengthens the cornea and slow down or prevents progression of the disease.

Intracorneal rings implantation

The technique of corneal segments implantation into the deep layers of the corneal stroma is widespread. This surgical procedure contributes not only to the prevention of the progression of pathological process and its stabilization, but also to a significant increase in visual acuity. At the same time, the formation of a tunnel in the layers of the cornea can be performed by the surgeon both mechanically and with femtosecond laser assistance, when robotic laser surgery provides a high accuracy in calculating the depth of the tunnel, its configuration and clearly verified position relative to the central visual axis of the eye.

The rings are rigid plastic segments which are inserted deeply in the periphery of the cornea. The rings reshape the curvature of the cornea from within, reducing the severity of the bulging. The aim of implanting intracorneal ring segments is not to treat or eliminate the existing disease, rather a surgical alternative to decrease the astigmatism and corneal abnormality and thus increase the visual acuity to acceptable limits, aiming to at least delay, if not eliminate, the need of corneal grafting. Since its release, intracorneal ring segment implantation for keratoconus seems to be an effective and, most of all, reversible treatment with minimal complications.

To treat the disease in the later stages, the Department’s surgeons use deep anterior lamellar keratoplasty, during which the corneal stroma is peeled off from the Descemet membrane. The improvement in visual acuity as a result of such an operation is comparable to the results of penetrating keratoplasty. At the same time, the preservation of the recipient corneal endothelium reduces the risk of graft rejection, as well as the risk of developing cataracts in the postoperative period.