Keratoconus treatment

Causes of Keratoconus

Dr. Amr Sheta indicates that the exact causes of keratoconus are still unknown, but it may be due to genetic factors, incorrect practices, or a balance disorder in the enzymes present in the cornea itself.

We can identify the risk factors for developing keratoconus as follows:

- Genetic factors, with one or both parents having keratoconus.
- Frequent eye rubbing due to eye inflammation or allergies.
- Certain medical conditions such as Down syndrome, asthma, and others.
- Excessive exposure to ultraviolet rays.
- Excessive and prolonged use of poorly made contact lenses.

Risks of Keratoconus

The risks of keratoconus extend beyond weakening vision or causing myopia. Ignoring proper treatment and allowing the condition to progress can lead to:

- Scarring of the cornea, which impairs vision.
- Bulging or swelling of the cornea, accumulation of eye fluids inside the cone-shaped area, causing serious vision problems.
- Developing the condition to the extent that it requires corneal transplant surgery.

Symptoms of Keratoconus

Dr.ibrahim osama notes that early detection and treatment in the initial stages are easier, but the question here is how the patient realizes that they need to undergo an examination to detect the problem early on. Typically, patients with keratoconus experience a range of symptoms, including:

Blurry vision.
- Excessive sensitivity to bright lights.
- Constantly changing prescriptions for corrective lenses.
- Multiple light shadows.

The stages of keratoconus are a progressive disorder of the eye where the cornea, which is usually round, thins and changes shape, causing it to weaken and bulge into a cone-like shape. This progressive development occurs in three consecutive stages, which are as follows:

Stage 1:
This stage involves minor changes in the cells lining the cornea and differences in visual measurements, but the patient can still see well with the help of glasses or contact lenses. Glasses or contact lenses may be an effective and sufficient solution, and in some cases, the doctor may perform a procedure to stabilize the cornea to prevent it from deteriorating.

Stage 2:
This is the next stage where vision does not improve with the use of prescription glasses, and the patient may require a procedure called corneal ring implantation, which aims to modify the surface of the cornea to remove the excess curvature.

Stage 3:
This is the most severe stage where the corneal tissue becomes extremely thin, and the patient may see halos or clouds in their field of vision that cannot be corrected with glasses, corneal stabilization, or ring implantation. The only remaining option is corneal transplantation because the cornea is too thin to allow any surgical intervention on the current cornea.
The stages of developing keratoconus typically begin in adolescence or early adulthood and progress until around age 40 when the development of keratoconus stops.

Treatment of Keratoconus
As mentioned in the previous paragraph, treatment is determined by the stage of the condition. The following are the treatments for each stage:

Treatment for Stage 1 Keratoconus:
The patient can still see well with prescription glasses, but corneal stabilization is a preferred procedure to prevent the condition from progressing. Corneal stabilization is performed as follows:

The surgeon saturates the cornea with a compound of riboflavin drops.
Appropriate doses of ultraviolet rays are applied to the surface of the cornea.
The ultraviolet rays enhance the links between collagen fibers in the corneal tissue, thereby strengthening it.
Corneal stabilization has a high success rate of up to 99% in preventing the deterioration of the cornea.

Treatment for Stage 2 Keratoconus:
Prescription glasses are ineffective in improving the patient's vision at this stage, and the doctor may decide to implant tiny supports or rings into the cornea using femtosecond laser technology. These rings help reduce the impact of scarring and curvature present in the cornea, leading to improved visual quality. In some cases, if the cornea is not sufficiently thick, the doctor may use surface laser to correct corneal curvature before corneal stabilization with ultraviolet rays and riboflavin drops.

The procedure for implanting rings to treat keratoconus is performed as follows:

The patient is given local anesthesia.
A special tool is used to separate the upper eyelid from the lower and widen the eye for surgery.
The rings are inserted through a small incision made by the surgeon at the edge of the cornea to pass the rings through a tunnel between the corneal layers.
The rings are then secured, and the incisions are closed.

Treatment for Stage 3 Keratoconus:
At this stage, the patient may experience cloudiness or halos in their field of vision that impede visual quality. Any attempts to reshape the corneal surface are ineffective due to the cornea's thinness, and the doctor will decide to perform a partial

LASIK or Femto-LASIK - Which Type of LASIK Surgery is Suitable for Me?

Which type of LASIK is suitable for me?

If you suffer from any vision-related issues that require you to wear prescription glasses or contact lenses to correct them, and you want to get rid of this option, then you need to undergo one of the vision correction surgeries. However, as you may know, there are many types of vision correction surgeries, including LASIK, Femto-LASIK, SMILE, and others. So, which type of LASIK is suitable for you?

Although determining the type of surgery is the doctor's job, it is important for you to be aware of how to choose the right type of surgery according to your individual case. Dr. Ibrahim Osama - a Doctor of Ophthalmology and consultant in corneal surgeries, cataract surgeries, and vision correction - explains in this article a comprehensive guide on how to choose the right type of vision correction surgery based on the patient's individual case. So, don't miss reading our article till the end.

Vision Correction Surgeries

Vision correction surgeries refer to a set of medical procedures used to correct vision-related issues using modern technology to improve visual quality without the need for prescription glasses or contact lenses.

Performing vision correction surgeries offers many benefits, such as treating various problems like nearsightedness, farsightedness, presbyopia, and astigmatism.

Types of Vision Correction Surgeries

Dr. Amr Sheta points out that modern technology has made a huge leap in creating different solutions to correct various possible problems. We now have a variety of surgeries that suit specific cases. The most prominent types of vision correction surgeries include:

PRK (Photorefractive Keratectomy)

In PRK, the outer layer (epithelium) of the cornea is separated from the rest of the layers using a very precise medical scalpel. The separated layer is then lifted, and the laser beam is directed onto the remaining part of the cornea to adjust its surface according to the degree of visual impairment. The epithelial layer is then placed back onto the cornea, and it takes at least a day to heal.

The drawbacks of this type of vision correction surgery include:

- Pain for the first three days after the surgery.
- The need for home rest for a period after the surgery.
- Extreme light sensitivity during the first 15 days after the surgery.

Ultra-LASIK (Custom LASIK)

Ultra-LASIK involves taking an eye print and customizing the laser to the exact measurement of the cornea to treat vision problems and astigmatism.

The first layer of the cornea is lifted using a surgical scalpel, and then the eye print is taken to customize the laser beam to the correct measurements to treat vision problems and distortions. After the procedure, the epithelial layer of the cornea is placed back in its original position, and the person needs at least 6 hours for the cornea to heal.

Femto-LASIK (Femtosecond LASIK)

Femto-LASIK is similar to LASIK, but in this procedure, the separation of the epithelial layer from the cornea is done using a femtosecond laser (Femto), which means higher precision and safety. It also allows for better control over the thickness of the separated layer to achieve the best possible results.

Femto-SMILE (Small Incision Lenticule Extraction)

Femto-SMILE is the latest technology used to correct vision problems, and unlike LASIK and Femto-LASIK, no layer of the cornea is separated, allowing people with thin corneas to undergo this procedure and eliminate the need for glasses.

During the procedure, the femtosecond laser is directed onto the cornea to create a small, precise layer of corneal tissue, which is then extracted through a small opening in the cornea without separating any layers.

The advantages of Femto-SMILE include:

- Better results than other procedures.
- The patient can resume normal activities immediately after the procedure.
- No corneal flap means no dryness after the procedure.

Conditions for Vision Correction Surgery

Not everyone with vision problems can undergo vision correction surgery. Some conditions that must be met before the surgery include:

• Wearing glasses or contact lenses.
  - No eye diseases.
  - Over 18 years old.
  - Stable vision for at least a year.
  - Necessary medical tests, including measuring vision with an eye chart, examining the retina, examining the vitreous body, and imaging the cornea.
  - Special tests for the procedure to determine the thickness and curvature of the cornea. The doctor will evaluate the results to determine if the person is a suitable candidate for the procedure.

Which Type of LASIK Surgery is Suitable for Me?

Perhaps the most common question we receive is which type of LASIK surgery is suitable. In fact, determining the appropriate surgery type depends on the patient's condition, and the doctor makes the decision after:

- Examining the cornea with great precision.
- Identifying the patient's vision measurements.
- Checking the thickness of the cornea and the condition of the retina.

This is because every cornea is different, and based on the thickness of the cornea and the degree of vision impairment, the doctor determines the most appropriate surgery for the patient.

However, if you have a suitable corneal thickness for all types of LASIK surgeries, you can choose according to the following:

- Surface ablation LASIK is suitable for people who plan to apply to military colleges and do not want to reveal this during the medical examination. However, the patient must have sufficient corneal thickness, and the degree of vision impairment should not be severe.
- Femto-LASIK is suitable for people who have thin corneas.
- Femto-SMILE provides the highest safety ratio and best results in the shortest possible time.

Best Doctor for Vision Correction Surgery

Dr. Amr Sheta, PhD in Ophthalmology and Eye Surgery, a consultant in corneal surgery, cataract surgery, and vision correction, is one of the most important and best eye surgeons in Egypt. You can undergo any of the vision correction surgeries with him without any worries:

- Dr. Amr has extensive experience and a high degree of knowledge in various types of eye surgeries. 
- Dr. Amr has performed thousands of successful surgeries, including LASIK, Femto-LASIK, and Femto-SMILE.
- His private center has the latest technologies and outstanding technological solutions to perform successful surgeries and achieve the best results.
- His high flexibility and broad-mindedness enable him to reassure the patient and understand their fears.
- Dr. Amr follows up continuously with every patient to ensure their complete recovery without any risks or complications.

In conclusion, there is no need to delay if you need to get rid of those annoying glasses. Don't waste any more time, contact us and book your appointment with Dr. Amr Sheta to determine which type of vision correction surgery is suitable for you. There is no need to worry about the type of surgery and its results; we have always been successful in that mission. Just book your appointment now.