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Archive for the 'Keratoconus References' Category

Corneal Collagen Crosslinking with Riboflavin treats Keratoconus

Thursday, November 20th, 2008

Here is an article presented in Ophthalmology Times:

Collagen crosslinking shows promise for keratoconus sill more prospective clinical data needed to characterize risks and benefits

Publish date: Oct 15, 2008
By: Cheryl Guttman
Source: Ophthalmology Times

Key Points

  • Research to date involving stress-strain measurements has shown that the collagen crosslinking procedure causes mechanical stiffening of the cornea.
  • Dr. Seiler’s current treatment protocol for collagen crosslinking involves a partial corneal abrasion performed over a diameter of 9 mm.
  • According to Dr. Seiler collagen crosslinking using ultraviolet A light and the photosensitizer riboflavin has been effective in stopping the progression of keratoconus in almost all eyes, and it has induced regression in about half of treated eyes based on reductions in keratometry readings. However, more prospective clinical data is needed to characterize its risks and benefits and to establish a list of indications and contraindications for this procedure.

Results achieved with corneal collagen crosslinking for the treatment of keratoconus are very encouraging, although the technique still must be considered investigational due to a lack of sufficient data published in the peer-reviewed literature, said Theo Seiler, MD, PhD.

“In our experience, collagen crosslinking using ultraviolet A light and the photosensitizer riboflavin has been effective in stopping the progression of keratoconus in almost all eyes, and it has induced regression in about half of treated eyes based on reductions in keratometry readings,” said Dr. Seiler, professor and chairman, Department of Ophthalmology, University of Zurich, and medical director, Institute for Refractive and Ophthalmic Surgery, Zurich, Switzerland. “However, we clearly need more prospective clinical data to characterize its risks and benefits and to establish a list of indications and contraindications for this procedure.”

Research to date involving stress-strain measurements has shown that the collagen crosslinking procedure causes mechanical stiffening of the cornea. Corneal rigidity, as assessed by Young’s modulus, increased by more than 4-fold after the procedure, Dr. Seiler said.

In addition, experiments performed with porcine corneal buttons show the treatment results in increased resistance of the extracellular matrix to enzymatic digestion compared with native corneal collagen. “The underlying mechanism for this latter effect of the crosslinking procedure is unknown, but it may play a role in the posttreatment reconstruction of the cornea,” he said.

He also said his current treatment protocol for collagen crosslinking involves a partial corneal abrasion performed over a diameter of 9 mm. Then a solution of 0.1% riboflavin in 20% dextran is dropped on the cornea approximately every 3 minutes for 30 minutes. The treated cornea is irradiated for 30 minutes with a 365-nm ultraviolet light source at a distance of 5 cm using an intensity of 3 mW/cm2.

“An alternative technique proposes using topical tetracaine to digest the epithelium and enable diffusion of the riboflavin into the stroma,” Dr. Seiler said. “However, using confocal microscopy, we found there is keratocyte damage to a depth of about 300 to 350 m using our crosslinking technique with corneal abrasion, whereas with the use of tetracaine, normal reflections from keratocyte nuclei can already be seen below the anterior 20 m of stroma. Therefore, it appears there is significantly less free radical formation and crosslinking of collagen fibers using the latter technique.”

He also noted that both the mechanical and biochemical effects of the procedure are very sensitive to the treatment parameters with respect to the concentration of the riboflavin solution used and the duration of application. Therefore, he encouraged that the efficacy of any modified protocol be investigated carefully prior to adoption in clinical use.

To date, Dr. Seiler and colleagues at the Technical University of Dresden, Dresden, Germany, have treated about 700 eyes with collagen crosslinking. Follow-up extending to 4 years shows the benefits are durable. An analysis including 21 patients with bilateral keratoconus who underwent crosslinking in only one eye showed the keratoconus index was increased in the untreated eyes after 1 year and significantly was higher than in the fellow crosslinked eyes.

“Crosslinking was not performed randomly in these patients but rather was used to treat the worse eye,” Dr. Seiler said. “Comparisons in individual patients showed there was a significant difference in the keratoconus index between the treated and untreated eye after 1 year in nearly all patients, and the difference between eyes was highly statistically significant in some cases.”

The safety profile of corneal collagen crosslinking has been favorable as well with very few complications recorded. Epithelial healing was delayed in some eyes and resulted in a subepithelial scar. More recently, in some eyes in which the procedure was repeated, a small scar in the anterior segment occurred that persisted for up to 6 months.

Same Experienced Keratoconus Surgeon, New Location in San Jose

Tuesday, November 27th, 2007

Although Dr. Turner has previously been performing Keratoconus Correction in San Jose, Turner Eye Institute has a new location in Campbell, California. Dr. Stephen Turner is well-known throughout California as one of the most experienced Keratoconus surgeons. He is also known for his innovation and excellent results with intacs and other methods of keratoconus correction. Dr. Turner introduced many of todays most successful eye surgery procedures to Northern California, Oakland, San Jose, San Francisco, and Walnut Creek. The advanced Crystalens procedure for improving near vision, the exciting Visian procedure for patients with moderate to high near-sightedness, and the precision of Wavefront LASIK, Intra-Lase, and TF LASIK were all introduced by Dr. Stephen Turner.

The new location in Campbell, CA contains the same advanced technology including the upgraded VISX laser with iris tracking software. San Jose patients can therefore expect the same high level of treatment in Campbell, CA that they had at each of the Turner Eye Institute locations, including San Jose, San Francisco, Walnut Creek, and Oakland. Dr. Turner will perform keratoconus procedures at each of the four locations in Northern California.

Turner Eye Institute performs cataract surgeries and other vision corrective procedures in San Leandro, CA (South of Oakland and north of Fremont). The surgical center provides a sterile environment to provide the highest level of safety for our patients.

Could Embryonic Stem Cell Research Cure Keratoconus?

Monday, June 11th, 2007

News has been released that British scientists are planning to use embryonic stem cells to cure age related macular degeneration, a common form of blindness. They are hoping to have the first patients receive test treatments within five years. This could be a major improvement in the methods of treating this common form of eye blindness that is experienced by millions of individuals throughout the world.

The pioneering project uses cells derived from human embryonic stem cells to repair damaged retinas. Those who support the research believe the process will involve simple surgery that could one day become as routine as cataract operations. Scientists are suggesting that the technique might be capable of restoring vision in patients with age-related macular degeneration (ARMD), a leading cause of blindness among the elderly that afflicts millions of people worldwide and is the leading cause of blindness in the USA and Europe.

If stem cell research can be used to cure age-related macular degeneration, could it also cure keratoconus? In April 2005, doctors in the UK transplanted corneal stem cells from an organ donor to the cornea of a woman who was blinded in one eye when acid was thrown in her eye at a nightclub. The cornea, which is the transparent window of the eye, is a particularly suitable site for transplants. In fact, the first successful human transplant was carried out in 1905 on a cornea by Dr. Eduard Zirm. The cornea has the remarkable property that it does not contain any blood vessels, making it relatively easy to transplant. The majority of corneal transplants carried out today are due to a degenerative disease called keratoconus which causes vision impairment and has no known cure even after corneal transplant. It is hoped that stem cell research will one day provide a cure to such debilitating corneal disorders.

The first step would be to grow corneas from a living donor. The corneas could then be transplanted into the person’s eyes. The advantage to using a patient’s own tissue would be a reduction in the possibility of rejection and a decrease in medications required to suppress a patient’s immune system.

Later steps might involve injection of healthy corneal cells into a keratoconic cornea in order to increase the strength of the cornea tissue. Stem cells could help reinforce the cornea and prevent the loss of vision that accompanies the progression of keratoconus.

Possible Keratoconus?

Wednesday, February 7th, 2007

I recently met a lady near Walnut Creek (in Conta Costa County) who was asking for the best corneal transplant surgeon in the San Francisco Bay Area. Her friend was located in the South Bay and San Jose and apparently was suffering from some form of degenerative corneal condition that eventually would require a corneal transplant. She was hoping to find the best surgeon to perform this procedure.

I began to quest the lady regarding the condition, which I had begun to suspect might be keratoconus. Apparently, her friend’s vision was fine until arriving into adulthood. At this time the vision deteriorated and needed to be corrected with hard contact lenses. I guess that soft contact lenses were not providing adequate vision. Her friend’s vision, however, was now becoming unsatisfactory even with hard contact lenses and she believed that a corneal transplant might be the only option now.

Her description of the patient’s symptoms sounded very much like keratoconus. I described to her the effects of keratoconus and told her that if her friend had keratoconus there was very likely to be a better option than a corneal transplant. While corneal transplants might still be performed, in the vast majority of cases, another option can either delay or prevent the need for a corneal transplant.

Many patients with keratoconus under intacs treatment. This requires placing a plastic band within the cornea which helps reinforce the cornea and can generally allow a patient with keratoconus to avoid needing a complete cornea transplant. The reinforced cornea can then often wear a hybrid contact lens designed to correct vision in a keratoconic patient. These contact lenses are part hard and part soft and are better for treating keratoconus because they provide the clear vision of a hard contact lens and the comfort of a soft contact lens.

The lady was grateful for the information a told me she would contact her friend. I am hoping that I was able to help. Keratoconus can often be a very painful and debilitating condition that requires long term care. Keratoconus patients often feel that they are not given the treatment that they require. Luckily, intacs and hybrid contact lenses have significantly improved the vision and comfort of patients with keratoconus.

If you have keratoconus or know someone who does, please contact Turner Eye Institute so that we can provide the best quality care and give them the chance to avoid a cornea transplant. There are option that exist that can provide better vision and greater comfort for patients suffering from keratoconus.

Keratoconus Advances in 2007

Tuesday, January 2nd, 2007

Patients with keratoconus are constantly seeking the best treatment for their eyes. Many of those dealing with keratoconus feel that the treatment they have received thus far has been unsatisfactory. What can keratoconus patients expect for 2007?

FDA trials are already underway and past the early stages in a variety of vision related trials. Early results for C3-R treatment have been promising but this treatment has not yet been FDA approved. There are several surgeons who perform C3-R treatment off-label but thus far it is not yet endorsed by the US FDA. We will likely see further results at Ophthalmological Seminars regarding the efficacy of this treatment.

Contact lens treatments for keratoconus are also advancing and increased research in this area can be expected in 2007. Synergeyes offers a new hybrid lens for keratoconus patients and so far results with this treatment have been excellent. We can expect more keratoconus patients to be fit with the newer hybrid lenses (a blend of hard and soft lenses). As practitioners gain more skill in fitting these lenses, we can expect results to continue to improve.

The Help Keratoconus blog will continue to offer new information in 2007 and continue to provide new findings concerning keratoconus as well as offer new options in treatment. Continue to visit the blog on a monthly or biweekly basis as new blogs try to offer the newest insights into keratoconus.

Addition Technology Receives FDA Approval for Intacs for Keratoconus

Tuesday, December 5th, 2006

Medical Device may restore visual function for patients with keratoconus and could defer the need for corneal transplant for moderate to severe keratoconus

DES PLAINES, Ill. Aug. 4, 2004 Addition Technology, Inc., the manufacturer of Intacs prescription inserts for surgical vision correction, announced today that it has received approval from the U.S. Food and Drug Administration (FDA) for a Humanitarian Device Exemption (HDE) to market Intacs inserts for the treatment of keratoconus. Keratoconus causes a progressive thinning of the cornea and affects up to 300,000 people in the United States.

The FDA approval is based on Intacs excellent safety record, the relatively low number of U.S. patients affected by keratoconus, and the fact that no other treatment options exist for patients with keratoconus other than an invasive corneal transplant procedure. The approval allows Intacs inserts to be marketed for the reduction or elimination of myopia and astigmatism in patients with keratoconus, where functional vision is no longer achievable with their contact lenses or eyeglasses. In addition, Intacs inserts may defer the need for a corneal transplant for some keratoconus patients.

The FDA approval will allow Addition Technology to educate keratoconus patients about the potential advantages of Intacs inserts and is expected to help facilitate expanded health insurance coverage for the procedure in the United States.

“Keratoconus sufferers now have a new option when it comes to restoring and improving their vision,” said William M. Flynn, president and chief executive officer of Addition Technology. “Intacs inserts fill a significant gap between rigid contact lenses and corneal transplantation for these patients.”

“For many of my patients, Intacs provide a solution to obtaining functional vision where contact lenses no longer suffice,” said Yaron Rabinowitz, M.D., of Cedars Sinai Medical Center in Los Angeles, Calif. “Before Intacs inserts, the only option was a corneal transplant, which I prefer to be a last resort for these patients.”

“In the past few years my condition caused my astigmatism to increase to the point where I couldn’t wear contact lenses comfortably and my best corrected spectacle correction was deteriorating each year. Even though the morbidity risk was low, I was reluctant to consider corneal transplantation, since the convalescent period was lengthy and as an ophthalmic surgeon, I needed good binocular vision to continue to operate,” said ophthalmologist Leslie A. Eisner, M.D. of Stamford, Conn. “Intacs in my right eye has improved and stabilized my vision, allowing me to resume my normal activities without undergoing a highly invasive transplant procedure. I can now wear soft toric contact lenses comfortably and with good vision. I’m so pleased with the results that I plan to have the left eye done this winter.”

Addition Technology, Inc., a privately held company, is the manufacturer of Intacs prescription inserts, the only corneal implant approved by the FDA. Intacs inserts are also approved for distribution in Europe, Asia, and Latin American countries that include Mexico. For more information on Intacs prescription inserts, visit www.helpkeratoconus.com or call 1.800.339.2733.

In the future, Implantable Contact lenses might replace LASIK Surgery

Tuesday, October 3rd, 2006

In the future, Implantable Contact lenses might replace LASIK Surgery.

While LASIK is the most popular form of surgical vision correction today with over a million Americans undergoing the procedure each year, that might change in the future. Implantable Contact Lenses, such as Visian ICL, might be the next wave of vision treatments. Unlike LASIK, Implantable Contact Lenses can treat high amounts of near-sightedness, dry eyes, thin corneas, and possibly even patients with diseases such as keratoconus.

In a comparative study of patients who underwent LASIK and/or Visian ICL it was discovered that the Visian ICL not only compared favorably to LASIK surgery but in fact exceeded the results of LASIK surgery in many categories.

Patients who were in the 8-12 range of myopia were seen to favor Visian over LASIK in a majority of cases. While LASIK has been clinically approved for near-sighted prescriptions as high as -14.00, many doctors avoid LASIK in prescriptions higher than -8.00 or -9.00. Cases of higher near-sightedness, occasionally have problems with dry eye, glare, haloes, and even more serious complications such as corneal ectasias or loss of best corrected vision.

In one study of 769 eyes that underwent LASIK or Visian ICL, the results demonstrated that the visian icl provided better quality of vision. After 1 year 90% of eyes (-8 to -12)that underwent treatment with the Visian ICL were able to read 20/20 visual acuity. LASIK eyes (-8 to -12) showed a much lower percentage of eyes seeing 20/20. While LASIK has a very high percentage of patients seeing 20/20 for low prescription cases (often more than 95% in cases below 3 diopters of near-sightedness), the success rates are lower for patients with high amounts of near-sightedness.

In fact, the Visian ICL has demonstrated that as many as 50% of patients will have vision that is significantly better than their glasses or contact lenses (1 line or more of increased best corrected visual acuity). While Wavefront custom LASIK has proven better results for LASIK, it still does not reach the level of improvement that is achieved by high myopes with a Visian ICL lens.

Not only are the results with a Visian ICL more accurate, but they are also more stable and more predictable. LASIK tends to cause vision fluctuations throughout the first year as the cornea’s tear film changes, healing occurs, and the shape of the cornea reacts to the thinning that occurred. Visian ICL showed a 99% stability in comparison to LASIK which was considered to be 91% stable.

Visian ICL is often recommended for patients with high amounts of near-sightedness, thin corneas, or irregular corneas. It can also be recommended for cases where dryness is a problem or where glare and haloes could cause serious difficulties.

Visian ICL and other phakic IOLs are likely to increase in popularity. Advances in lens technology could eventually overtake LASIK technology. Lenses can avoid the necessity of thinning the cornea and can be designed with superior optics. Lenses can also be placed closer to the nodal point of the eye allowing greater magnification and improved acuity.

While LASIK surgery has been very effective in treating near-sightedness, far-sightedness, and astigmatism, some people believe that the future of refractive eye surgery might lie in intraocular lenses, especially with reversible procedures such as the phakic IOL.

Look to see future advances in these lenses make headline news and eventually perhaps replace LASIK surgery as the standard for vision correction.

Turner Eye Institute was the first LASIK and refractive surgery center in the San Francisco Bay Area to provide Visian ICL treatments. Dr. Turner has trained numerous doctors in this procedure and has performed Visian treatments upon patients from San Jose, Oakland, Walnut Creek, San Francisco, and other Bay Area locations.

If you are interested in learning more about Visian ICL treatment or LASIK please contact our LASIK coordinators. They will be happy to discuss your options and arrange for you to meet with Dr. Turner for an evaluation.

She came to see again – A keratoconus story

Tuesday, September 12th, 2006

This article about a patient with keratoconus was in the Concord Monitor Newspaper:

She came to see again
By SARAH LIEBOWITZ
Monitor staff
September 11. 2006 at 8:00AM

Near-blindness forced Ndofor Claire, 13, to leave school. In her native Cameroon, Africa, she held books inches from her face, straining to read. Without a corneal transplant, her local doctor said, Claire would go blind.

In Concord, Claire found her sight.

Two weeks ago, a local ophthalmologist transplanted a donated cornea into one of Claire’s diseased eyes. The procedure – which Erin Fogel, a doctor at the Eye Center of Concord, performed free of charge -will allow Claire to wear glasses, restoring her sight. The transplant took place at Concord Hospital, which donated its services.

Claire’s left eye will take time to heal. “But when the days pass, it becomes clearer and clearer,” she said.

Claire’s path to Concord began with a Cameroonian doctor.

She suffers from keratoconus, which causes a distortion or thinning of the cornea. Last year, her sight deteriorated rapidly. Her local ophthalmologist contacted Munro Proctor, a retired Concord doctor who has made numerous trips to Cameroon to provide medical assistance, Fogel said. Leaving the country was Claire’s only chance, Fogel added: There are no corneal surgeons in Cameroon.

Proctor asked Fogel to donate her services. Concord Hospital provided an anesthesiologist and a surgical room, free of charge. Tissue Banks International, a nonprofit network of eye and tissue banks, donated the cornea. Claire’s family organized the trip to Concord, sending Claire first to Baltimore, where she stayed with family friends, and then to New Hampshire.

Claire “is very sweet and very good and has been grateful at every step,” Fogel said. “She told me she wasn’t scared, and I didn’t believe her. But I think she may not have been.”

Keratoconus usually strikes in late adolescence or early adulthood, Fogel said. Often, glasses or contact lenses can rectify the disease. Claire – who has the disease in both eyes – suffers from a particularly severe case, and she could need another transplant on her right eye.

The transplant was the first one that Fogel has donated. It likely won’t be the last. “I always had plans, not so much to bring patients here, but to go somewhere to do eye care in a Third World country. And that will happen,” she said.

To hear Claire tell it, the surgery didn’t faze her one bit. “I didn’t even know they were doing something,” she said. “I was happy to see again.”

In the meantime, the surgery has afforded Claire a lengthy visit to the United States, and, by extension, her first glimpse at MTV, super-sized grocery stores and late-summer leaves beginning to change hue. In New Hampshire, where Claire will remain for two more weeks, she fell in love with pizza, mashed potatoes and Dunkin’ Donuts hot chocolate. She learned she doesn’t like oatmeal and put the English she learned in school to use. Last week, she took her first boat ride.

The trip has seemed so vacation-like that Claire isn’t ready to fly home. “I’d like to stay,” she said, shyly. Claire has lived with a host family in the Concord area. (Family members didn’t want their names included in this story because they don’t want the recognition.) Mary Peteh, a native of Cameroon who lives in Baltimore and is a friend of Claire’s family, accompanied Claire to New Hampshire. When Claire leaves the state, she’ll head to Baltimore with Peteh.

Two months later, she is due to return to Bamenda, a city near Cameroon’s western border, where her father is a math teacher and her mother works as a nurse. She’ll see her ophthalmologist, who will remove the remaining sutures holding Claire’s new cornea to her eye. She’ll trade mashed potatoes for rice and local fruits. And she will return to school, with the hopes of one day attending a university.

But Friday afternoon, Cameroon seemed a long way off. Claire and Peteh were headed for a distinctly American destination: the mall.

This story discusses one person’s treatment of keratoconus.
In many cases a corneal transplant is not necessary and there are other options that can help treat and improve the possible symptoms of keratoconus. If you have been diagnosed with keratoconus and/or suspect that you might have keratoconus, we recommend that you meet with a corneal specialist to determine what is the best treatment for you.

Girl Scout writes about Keratoconus

Tuesday, September 5th, 2006

The following was written by members of the Wayland Girl Scout Troop #3178:

Last spring, Wayland Girl Scout Troop #3178 visited the Boston Foundation for Sight in Needham as part of their Bronze Award community service project. After months preparing and learning about the foundation’s work and studying journalism, the fifth-graders were lucky enough to have an insider’s view of the foundation and to meet with the staff and several patients to conduct interviews.

The troop members are Abi Agoos, Courtney Bolivar, Hannah Brigham, Paige Gould, Sarah Kaye, Bar Kinreich, Julia Lavenson, Regan McLaughlin, Kira Palmer, Melissa Sax, Natalie Shear and Kruti Vora. Troop leaders are Nancy Gould, Barbara Krause and Cynthia Lavenson. Lavenson was a longtime board member of the foundation.

The Boston Foundation for Sight is a nonprofit dedicated to helping children and adults who suffer from various types of corneal illness or disease, regardless of their ability to pay.  Founded by Dr. Perry Rosenthal, the treatment involves custom-fitting a special contact lens which serves as a liquid bandage, relieving eye pain and enhancing vision.

Cyndee Williams of Dexter, Mo., is one patient who was interviewed by the Girl Scouts. She is a stay-at-home mom, and she and her husband have two young children. She was blind which was difficult. She has been diagnosed with “keratoconus,” a disease that thins the cornea, which is the clear, dome-shaped surface on the front of the eye.

After a frightening experience with her son running off from the backyard, Williams decided she needed to find help. She learned of the Boston Foundation for Sight from “The Oprah Winfrey Show.” Dr. Perry Rosenthal, MD, a Harvard ophthalmologist, appeared on “Oprah” to talk about the “scleral” lens he invented. This lens was able to help people like Williams to see again.

Williams had been suffering with the disease for eight years. She also has two cousins with the same disease. One cousin had a successful corneal transplant, but Williams didn’t want the transplant because it can be dangerous and not always successful.

The Foundation for Sight collects donations for help people who need it, and Williams’ lenses were free. After she got the lenses she was so happy she wanted to hug the doctor. “I could see everything!” she said. She told us she was the most excited to see her husband and kids again. She said the lenses do not hurt to wear and took about three days to learn how to put in and take out each day. Williams has to come back once a year to have the lenses checked.

The troop also met another patient named Ellen Kelly of Santa Barbara, Calif. Because of her leukemia and lymphoma she had a bone marrow transplant. Often with a bone marrow transplant the new blood cells attack the cells of the cornea in addition to fighting the cancer. Kelly was in terrible pain because she suffered from extreme dry eye. When her doctor told her about the foundation she was so nervous she was not able to make the call for four months. “I kept putting it off,” she said.

When she finally came to the foundation she found out all the workers and doctors were very nice. The doctors fitted her with special lenses, and the pain stopped as soon as the lenses were put in. When we met Kelly she had just been fitted with the lenses and was learning how to put them in and take them out, and how to clean them several times a day.

Kelly is a children’s book writer so the lenses make her work much easier. “Because this problem affects people’s lives so much, it’s so great these people can help,” she explained.

Lynette Johns is an optometrist who works at the Boston Foundation for Sight and treats almost 30 patients a week. She has been working there for about a year and loves her job because she feels good about helping other people.

After college she attended optometry school for four years. Then she began to work as a resident and that’s how she found out about the Boston Foundation for Sight. There are many patients and success stories she remembers. One person that Johns has treated was blind and now she is able to see! Another patient got married after coming for treatment and is now the mother of six! Johns is a great optometrist who loves her job and her patients.

We also met with Steve Corlett who works in the lens lab at the Boston Foundation for Sight. He had a person in training, learning how to work the special machines. These machines make custom fitted eye lenses for individuals.

At the foundation, they use a special machine called lathe. It has sharp diamonds for cutting the quarter-sized piece of oxygen permeable plastic to make the lenses. They use diamonds because they are hard enough to cut the tough material. One of the great things about these lenses is that they don’t hurt, as the lenses only touch the white part of the eye which is not very sensitive.

The executive director of the Boston Foundation for Sight is Mark Cohen. The creator of these miracle lenses is Dr. Perry Rosenthal. They are great people working to help others.

“Since the lenses can be very expensive, the BFS will pay if you can’t afford it. That is why this nice organization needs donations,” observed one of the Girl Scouts.

Keratoconus Patients and LASIK Surgery

Thursday, August 17th, 2006

Keratoconus patients are suffering from a disease that weakens the collagen structure within the cornea. This results in vision with decreased clarity. Many patients with keratoconus seek out surgical vision care in order to improve their vision. Some even wonder whether LASIK can correct their vision.

I recently read a story of a Merritt Island doctor who was fined and ordered to perform 50 hours of community service for inappropriately performing Lasik surgery on a patient in 2000. According to board documents, the LASIK surgeon failed to recognize that the patient had a condition — keratoconus — that prohibits Lasik surgery.

LASIK eye surgery thins the cornea. It can also lead to a condition known as ectasia. In this condition, the cornea bulges outward as the pressure within the eye pushes on the thinned cornea. Ectasia can appear remarkably similar to keratoconus and often a patient with ectasia following LASIK surgery will be diagnosed as having keratoconus.

With a keratoconus diagnosis the patient can then sue the LASIK surgeon for malpractice in performing LASIK upon an eye with keratoconus. The question is whether the eye had keratoconus prior to LASIK or if the thinning of the cornea caused ectasia which was then diagnosed as keratoconus. Other factors can also exacerbate the condition. Some medical problems, such as uncontrolled diabetes, thyroid conditions, or collagen vascular diseases, could also weaken the cornea and result in problems following LASIK eye surgery.

Certainly any patient considering LASIK eye surgery must feel comfortable with the experience and qualifications of the surgeon that they are choosing. The higher the prescription the more thinning is required so patients with a high amount of near-sightedness would then be at a higher risk for corneal ectasia. There are in fact other options, besides LASIK, that do not thin the cornea.

While ectasia resembles keratoconus, they are not considered the same disease. Keratoconus occurs in an eye that has not had LASIK treatment. Ectasia is the bulging of the cornea that is resulting from a cornea that is too thin, perhaps caused by LASIK treatment.

Both conditions can often be treated similarly however. Some LASIK patients who are suffering from ectasia can benefit from intacs treatment to strengthen the corneal foundation. Patients undergoing intacs for ectasia are very similar to patients having intacs for keratoconus.

If you are interested in having an eye examination to determine if intacs, LASIK, or other treatment is right for you, please contact Turner Eye Institute. Turner Eye Institute is located in the San Francisco Bay Area and has vision clinics in San Francisco, San Jose, San Leandro, and Concord. Dr. Turner treats patients throughout the San Francisco Bay Area, including Oakland and Walnut Creek as well as Santa Clara, Hayward, Fremont, and other East Bay cities.

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