From spectacles to contact lenses to surgery, what care is most beneficial at each stage of this progressive disease?

摘要

It wasn’t that long ago that the options for keratoconus management included only small-diameter rigid lenses and, in 10% to 22% percent of cases, a penetrating keratoplasty.1-8 Today, we have a broad and ever-increasing number of viable options including larger-diameter intralimbal corneal GPs, scleral lenses, hybrid lenses, and custom soft lenses.In addition, keratoplasty procedures have improved, and the recent U.S. Food and Drug Administration (FDA) approval of corneal cross-linking (CXL) provides an option that may slow or halt progression of the disease. The benefits and increasing popularity of new and more comfortable contact lens designs, combined with CXL’s effect on progression, should continue to reduce the number of individuals needing some form of keratoplasty procedure.This article will discuss the current management options for keratoconus and will present a continuum of care with recommended options for the many different types of patients who exhibit this corneal disease.