The Cornea is the first and most powerful lens of the eye, and critical for clear vision. The word Cornea means “tough and horny”, because its structure resembles an animal’s horn and it is tough because it forms the front wall of the eye.
With Keratoconus, the cornea is thinned and deformed into a cone shape. Patients experience both BLUR and DISTORTION but can’t tell the difference. Glasses, soft contact lenses, or hard contact lenses may help, however, to restore optical clarity, surgery may be required.
Keratoconus runs in families, occurs usually at a young age, affects both eyes differently and worsens with rubbing.
A patient may not be aware that they suffer advanced Keratoconus if one eye sees normally. When both eyes have severe disease, patients tend to adapt to the distorted vision and think they see normally.
In most cases, Keratoconus progression stops by ceasing eye rubbing. If not, collagen cross linking may help.
If vision does not improve with glasses, or if contact lenses become intolerable, Stromal Corneal Transplantation is the procedure of choice to restore vision. A Stromal Transplant replaces the stretched and thinned structural layer of the cornea with donated human corneal tissue, restoring the normal corneal shape and thickness. The risk of sight threatening endothelial rejection is removed, as is the risk of glaucoma and infection inside the eye. Furthermore because Stromal Corneal Transplantation replaces only PART of the cornea, the eye remains strong.
The Golden rules for transplantation success
These three rules must never be broken:
- NEVER RUB YOUR EYES
- Use your drops as prescribed
- Attend all your appointments
Not all patients can have Stromal Corneal Transplantation: if Keratoconus is left too long, the cornea may rupture so that a Full Corneal Transplantation is required. This can only be determined by assessment.
Typically, we advise up to 2 weeks off work, although you may return to work sooner if you feel well enough. We typically see patients at week 2, month 1, month 3, 6, 12. After this, you will have 6 monthly appointments until the stitches are removed. At no stage will you need anti-rejection tablets. Drops continue until stitches are removed, typically around 18 months.