Speaker:

Prof. Carina Koppen is chief of the department of Ophthalmology in the Antwerp University Hospital (UZA) and chair of Ophthalmology at the Faculty of Medicine and Health Sciences, University of Antwerp (UA).

Content:

When a new patient presents, we will inform him / her about the possibilities of UV crosslinking to stabilize the disease. In this session, examples will be provided of progressive keratoconus and the results of crosslinking in these patients. In addition, we explain to the patient that he / she should not rub the eyes because this is a very important factor that might affect cone progression.

Integrated care in collaboration with the optometrist ensures that the patient is given all options for vision correction: from optimally adjusted glasses to the most complex contact lens correction. For each individual patient we look for the best combination of vision improvement and comfort and for this we use the full range of specialty lenses: soft, hybrid, corneal and scleral. In our experience, soft and hybrid lenses do not live up to expectations. Rigid lenses, both corneal and scleral, remain the most commonly used lenses. Before proceeding with transplant surgery, the ophthalmologist must make sure that a contact lens fitting is no longer providing stable and good quality vision. For the severe forms of keratoconus, the use of scleral lenses helps us to limit the percentage of patients requiring surgery to a few percent at most.

As far as refractive surgery (laser, rings and implant lenses) is concerned, the application is rather limited to rather mild forms of keratoconus, whether or not in combination with cross-linking. In addition, the predictability of the results is problematic and complications are not rare.