Current review and a simplified “five‑point management algorithm” for keratoconus.
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Date
2015-01
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Abstract
Keratoconus is a slowly progressive, noninflammatory ectatic corneal disease characterized by changes in
corneal collagen structure and organization. Though the etiology remains unknown, novel techniques are
continuously emerging for the diagnosis and management of the disease. Demographical parameters are
known to affect the rate of progression of the disease. Common methods of vision correction for keratoconus
range from spectacles and rigid gas‑permeable contact lenses to other specialized lenses such as piggyback,
Rose‑K or Boston scleral lenses. Corneal collagen cross‑linking is effective in stabilizing the progression of
the disease. Intra‑corneal ring segments can improve vision by flattening the cornea in patients with mild
to moderate keratoconus. Topography‑guided custom ablation treatment betters the quality of vision by
correcting the refractive error and improving the contact lens fit. In advanced keratoconus with corneal
scarring, lamellar or full thickness penetrating keratoplasty will be the treatment of choice. With such a
wide spectrum of alternatives available, it is necessary to choose the best possible treatment option for
each patient. Based on a brief review of the literature and our own studies we have designed a five‑point
management algorithm for the treatment of keratoconus.
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Keywords
Algorithm, cross‑linking, Intacs, keratoconus, normogram
Citation
Shetty Rohit, Kaweri Luci, Pahuja Natasha, Nagaraja Harsha, Wadia Kareeshma, Jayadev Chaitra, Nuijts Rudy, Arora Vishal. Current review and a simplified “five‑point management algorithm” for keratoconus. Indian Journal of Ophthalmology. 2015 Jan; 63(1): 46-53.