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Keratoconus · Treatments
Surgical treatments
Slow, strengthen, regularize: modern, minimally invasive techniques to preserve your vision.
When keratoconus progresses or vision is no longer sufficiently corrected by glasses or contact lenses, several surgical treatments can be offered. The choice of technique depends on the stage of the disease, the thickness of the cornea and vision: it is decided after a complete work-up.
The techniques at a glance
Cross-linking (CXL)
Slow the progressionStrengthens the cornea’s collagen with riboflavin + UV to halt the progression. The reference treatment for progressive keratoconus.
StabilizationIntracorneal ring segments
Regularize the corneaThin rings inserted into the cornea regularize it and improve vision, often in addition to CXL.
VisionTopography-guided PRK + CXL
Refine the surfaceA laser guided by topography smooths the irregularities, combined with cross-linking to secure the result.
CustomSpecialty lenses
No surgeryRigid or scleral lenses fitted to the cone to restore clear vision when glasses are no longer enough.
Non-surgicalA corneal transplant is only considered in very advanced forms: it falls under hospital care, to which Dr Oulehri will refer you if necessary.
Corneal cross-linking (CXL)
Cross-linking, or corneal collagen cross-linking, aims to strengthen the cornea. By combining the application of riboflavin (vitamin B2) with ultraviolet light, it creates new bonds that stiffen the corneal tissue. Its goal is not to improve vision, but to stabilize keratoconus and halt its progression in the great majority of cases. It is the reference treatment for progressive keratoconus.
Intracorneal ring segments (ICRS)
Intracorneal ring segments are small polymer segments implanted within the thickness of the cornea. They reshape its curvature to make it more regular, which can improve vision and make wearing glasses or contact lenses easier. They are an option for certain forms of moderate keratoconus.
Topography-guided PRK combined with cross-linking
This approach combines a photorefractive keratectomy (PRK) guided by the topography of the cornea with cross-linking. It aims to regularize the corneal surface while stabilizing the disease. It can be offered in mild to moderate keratoconus, after evaluation.
What about corneal transplant?
In very advanced forms, when the cornea is too deformed or too thin and other treatments are no longer enough, a corneal transplant may be considered. It is a procedure performed in a hospital setting; the practice then refers the patient to the appropriate facility.
Which technique for which patient?
There is no single treatment: each keratoconus is different. Cross-linking stabilizes, rings and topography-guided PRK improve shape and vision, and contact lenses rehabilitate vision without surgery. It is the complete evaluation of the cornea that allows the choice, sometimes by combining several approaches.