Keratoconus

Corneal ectasia of disputed etiology which leads to cornea thinning and consequent deformation.


Treatments



FERRARA RING™
In the early stages of keratoconus, contact lens fitting or glasses can help patients. As the disease progresses, cornea thinning increases the irregularity of its shape and hinder the improvement once provided by glasses or lenses.

The Ferrara Ring® is a surgical alternative which delays or eliminates the need for corneal transplantation.

Keratoconus may be hard to detect and, habitually, emerges slowly. However, in some cases, keratoconus can progress rapidly. As the cornea shape becomes increasingly irregular, there is gradual vision loss. Glare and photophobia might occur as well.

Keratoconus patients tend to have their lens prescriptions renewed each time they visit their ophthalmologist. Quite frequently keratoconus diagnosis comes late if ophthalmologists are not familiar with such cases and do not identify the early stages of the disease.

Keratoconus is a progressive degenerative condition and can occur at any age in the life of a person. Most of patients are diagnosed early during adolescence, when the disease progresses more aggressively.

Major risk factors are heredity and allergic conjunctivitis normally associated with constant eye rubbing.

 

 

SCLERAL FITTING LENSES
Scleral lenses are larger-diameter contact lenses, suitable for irregular corneas, and can help keratoconus patients.
However, scleral lenses do not treat keratoconus and if its progression is observed, a Ferrara RingTM implant can be recommended.
CROSSLINKING
Crosslinking emerged as an approach in the treatment of keratoconus around 10 years ago.
Riboflavin application associated to ultra-violet light in controlled intensity strengthens corneal collagen structures making the cornea more rigid and resistant to deformation.
In advanced cases of keratoconus, a Ferrara RingTM implant is recommended to correct corneal irregularity and, in case of disease progression, Crosslinking application may be recommended.
CORNEA TRANSPLANT
A cornea transplant is the last resort for treating keratoconus.
Even after a transplant, a Ferrara RingTM implant might be made necessary if post-transplant/post-keratoplasty irregular astigmatism is significant.
Currently, 320°arc length segmentsmay be indicated for advanced cases of keratoconus and postpone the need for cornea transplant.
KERATOCONUS
Keratoconus is corneal ectasia of disputed etiology which leads to cornea thinning and consequent deformation into a conic shape, which triggers the occurrence of high regular astigmatism and consequent reduction of visual acuity.

Keratoconus is always bilateral and asymmetrical, and manifests during adolescence.
SYMPTONS
Keratoconus may be hard to detect and, habitually, emerges slowly. However, in some cases, keratoconus can progress rapidly. As the cornea shape becomes increasingly irregular, there is gradual vision loss. Glare and photophobia might occur as well.

Keratoconus patients tend to have their lens prescriptions renewed each time they visit their ophthalmologist.

Quite frequently keratoconus diagnosis comes late if ophthalmologists are not familiar with such cases and do not identify the early stages of the disease.
CAUSES
Keratoconus is a progressive degenerative condition and can occur at any age in the life of a person. Most of patients are diagnosed early during adolescence, when the disease progresses more aggressively.

Major risk factors are heredity and allergic conjunctivitis normally associated with constant eye rubbing.



Frequently Asked Questions

FAQS


WHAT IS THE SURGERY SUCCESS RATE?
95% of patients who have undergone Ferrara RingTM implantation do not need a cornea transplant.
DO CHANGES IN CORNEAL SHAPE CAUSED BY A FERRARA RINGTM IMPLANT HINDER OR PREVENT THE USE OF CONTACT LENSES?
In some cases, scleral lens fitting is made necessary. In most cases, though, glasses or gelatinous lenses will suffice.
DOES A FERRARA RING™ IMPLANT PRESENT ANY SIDE EFFECTS IN THE SHORT OR LONG TERM?
No. This surgical technique, when properly performed, is always beneficial to the cornea.
CAN COMPLICATIONS OCCUR DURING SURGERY?
Complications related to the surgical technique such as implants superficiality may result in spontaneous ring extrusion.Improper segment positioning may cause astigmatism but this is rarely observed. Complications related to inadequate post-operative care may occur when patients rub their eyes which could cause segment displacement, spontaneous extrusion or infection.
WHEN COMPLICATIONS OCCUR, WHAT ARE THE CONSEQUENCES FOR THE PATIENT?
In general, all complications are reversible with the removal or repositioning of Ferrara RingTM segments.
HOW OFTEN DO COMPLICATIONS OCCUR?
Surgery complications rarely occur. The segment removal rate is lower than 4% after the procedure.Infections can lead to more severe complications and may result in the need for a cornea transplant. Fortunately, infections have been observed in less than 0.08% of the cases.
HOW CAN YOU COMPARE A FERRA RINGTM IMPLANT A CORNEA TRANSPLANT?
A cornea transplant requires a long period of recovery, usually around 12-month long. This type of transplant also presents risk of rejection and does not prevent keratoconus from reemerging. In most cases, wearing glasses or contact lenses is made necessary, and the patient can furthermore have to resort to a Ferrara RingTM implant in order to correct a high degree of irregular astigmatism which may result from an Improper or poor transplant recovery.
WHAT ARE THE ADVANTANGES OF FERRARA RINGTM IMPLANTS?
. Patient’s quick recovery
. Compatibility between Ring material and cornea tissue;
. If contact lenses are needed, adaptationis easy;
. Reversibility;
. A Ferrara RingTM implant delays or ceases the progression of the disease for an indefinite period of time.
WHAT IS THE SUCCESS RATE FOR THE SURGICAL PROCEDURE AND HOW DOES IT VARY FOR EACH PATIENT?
The success rate depends on how severe the degree of keratoconus is. The sooner the surgery is performed, the higher the chances of success are. For early interventions, the success rate is above 95% of cases.
IS THE FERRARA RINGTM ALSO INDICATED FOR MYOPIA?
Ferrara ringTM implants flatten and regularize corneal surface thus correcting deformities such as myopia and astigmatism. Ferrara rings can also be used complementarily to laser or Phakic lenses to correct cases of high myopia.
HOW LONG DOES IT TAKE FOR THE PATIENT TO RECOVER VISION?
Vision recovery is quick. The day after surgery, the patient’s vision already shows improvement and stabilizes after three months. During this period fluctuations in vision quality may occur. While vision may be acute in the morning, it can otherwise present with higher blurring along the day. Prescription of glasses or contact lenses may be needed for complete correction. Meanwhile, vision can become acute or slightly blurred.
WHAT RISKS DOES THE SURGERY PRESENT?
There are barely any risks related toFerrara RingTM implant surgeries.As with any other surgery, infections may occur. In such cases, Ferrara RingTM segments must be removed. Complications are minimal and, most importantly, reversible. This means that segments can be removed and the cornea returns to its original shape. There is no risk of orthosis rejection.
WHAT IS THE SURGERY LIKE?
Surgical procedures are performed under ambulatory care and full asepsis. Local anesthesia is applied by means of eye drops. Asepsis includes the region of eyes, nose and eyelids. After surgery, a healing lens or gauze is used to prevent contact with infectious agents. The procedure is painless and performed within about 10 minutes. The use of antibiotic and anti-inflammatory eye drops makes the postoperative period safer and more comfortable. The day after surgery, patients can resume their intellectual activities.
DO FERRARA RINGTM IMPLANTS SUBSTITUTE CORNEA TRANSPLANTS?
No. The main objective of a Ferrana RingTM implant is to achieve visual rehabilitation. A Ferrana RingTM implant can delay keratoconus progression preventing the need for a cornea transplant for indefinite time.
IS THERE A RISK OF BLURRED VISION AFTER THE SURGERY?
Most of the patients do not present complaints related to night vision. Corrective lenses may be necessary after a Ferrana RingTM implant to correct residual ametropia.