str. 18 – 22
Autor: Karolina Ciepiaszuk1,2, Anna Kurowska1,2,3, Justyna Izdebska1,2,3, Jacek P. Szaflik1,2,3
1 Centrum Mikrochirurgii Oka Laser w Warszawie
Kierownik: prof. dr hab. n. med. Jerzy Szaflik
2 Samodzielny Publiczny Kliniczny Szpital Okulistyczny w Warszawie
3 Katedra i Klinika Okulistyki Wydziału Lekarskiego Warszawskiego Uniwersytetu Medycznego
Kierownik: prof. dr hab. n. med. Jacek P. Szaflik
Keratoconus is progressive, noninflammatory ectasia that affects young adults, causes thinning and steepening of the cornea and leads to myopia, irregular astigmatism, decrease of visual acuity and in severe cases – visual impairment. Nowadays it is presumed that keratoconus is caused by genetic predisposition, combined with environmental factors. Clinical signs are observed in a moderate stage, but in preclinical (forme fruste) and early keratoconus the diagnosis is made based only on findings from corneal tomography and topography. Treatment depends on the disease’s stage and can be divided into causative and symptomatic. Corneal cross-linking is a causative treatment that uses ultraviolet-A-light and the photosensitizer riboflavin to stiffen the cornea and halt the disease’s progression. Among symptomatic modalities there are glasses, soft contact lenses, rigid gas permeable contact lenses, intrastromal corneal ring segments, photorefractive keratectomy, clear lens or cataract extraction with intraocular lens implantation. Corneal keratoplasty can be performed in advanced keratoconus with corneal opacities and loss of visual acuity, the two most commonly used techniques are penetrating keratoplasty and deep anterior lamellar keratoplasty. The first has better visual outcomes but more postoperative complications, the second is safer but its visual outcomes are poorer.