Our Summary

This research paper discusses a condition called keratoconus, where the outer layer of the eye, the cornea, weakens and thins. The paper reviews different treatments available for this condition. One method, corneal cross-linking, is becoming more popular but is only suitable for patients with less serious conditions and thicker corneas. For those with more advanced keratoconus, a new treatment called tissue addition keratoplasty has been developed. This method involves adding layers of tissue to the cornea to strengthen it. The paper explores different techniques of this treatment, which have shown to improve the shape of the cornea and overall vision. It also increased the successful fitting of contact lenses. The paper’s aim is to discuss the different options available for tissue addition keratoplasty.

FAQs

  1. What is keratoconus and how is it managed?
  2. What is tissue addition keratoplasty and how is it used to treat advanced keratoconus?
  3. What are the different techniques of tissue addition keratoplasty and their outcomes?

Doctor’s Tip

A doctor may advise a patient considering a corneal transplant for keratoconus to carefully consider all available options, including tissue addition keratoplasty techniques such as Bowman layer transplantation, corneal allogenic intrastromal ring segments, and intralamellar keratoplasty. It is important to discuss the potential benefits and risks of each technique with a healthcare provider to determine the best course of treatment for their individual case.

Suitable For

Patients who are typically recommended for corneal transplant include those with advanced keratoconus, corneal scarring, corneal dystrophies, corneal degenerations, corneal edema, and corneal infections that have not responded to other treatments. Patients with these conditions may experience significant visual impairment that cannot be corrected with glasses or contact lenses, leading to the need for a corneal transplant to restore vision. Additionally, patients with corneal thinning, irregular astigmatism, and corneal ectasia may also be candidates for corneal transplant surgery.

Timeline

Before corneal transplant:

  • Patient is diagnosed with keratoconus, a condition characterized by loss of corneal structural integrity causing stromal thinning
  • Patient undergoes various treatments such as corneal cross-linking to halt the progression of the disease
  • Patient experiences worsening vision, increased astigmatism, and difficulty with contact lens fitting as the disease progresses

After corneal transplant:

  • Patient undergoes tissue addition keratoplasty, such as Bowman layer transplantation, corneal allogenic intrastromal ring segments, or intralamellar keratoplasty
  • Patient experiences flattening of corneal keratometry and improved visual outcomes
  • Patient has increased rates of successful contact lens fitting and improved quality of life
  • Patient undergoes post-operative care and follow-up appointments to monitor healing and visual acuity

What to Ask Your Doctor

  1. What are the risks and potential complications associated with corneal transplant surgery?
  2. How long is the recovery process after a corneal transplant surgery?
  3. Will I need to take any medications after the surgery, and if so, what are they for?
  4. How successful is a corneal transplant in improving vision for patients with keratoconus?
  5. Are there any specific post-operative care instructions I should follow to ensure the success of the transplant?
  6. Will I need to have regular follow-up appointments after the surgery, and if so, how often?
  7. How long do corneal transplants typically last, and are there any factors that may affect the longevity of the transplant?
  8. Are there any alternative treatment options for keratoconus that I should consider before opting for a corneal transplant?
  9. How experienced are you in performing corneal transplant surgeries, and what is your success rate with this procedure?
  10. Are there any specific lifestyle changes I should consider making after the surgery to protect my eye health and the success of the transplant?

Reference

Authors: Ballouz D, Dmitriev PM, Ayres BD. Journal: Int Ophthalmol Clin. 2025 Apr 1;65(2):31-34. doi: 10.1097/IIO.0000000000000561. Epub 2025 Mar 21. PMID: 40116407