Keratoconus is a progressive eye condition that causes the cornea, the clear front part of the eye, to thin and bulge into a cone shape. This can lead to severe vision problems and even blindness if left untreated. Researchers have developed a groundbreaking new surgical technique called femtosecond laser-assisted minimally invasive lamellar keratoplasty (FL-MILK) that can effectively treat advanced keratoconus by increasing the thickness and flattening the curvature of the cornea.
The study, led by a team of ophthalmologists, found that FL-MILK significantly improved the corneal shape and thickness in keratoconus patients, allowing them to achieve excellent vision correction using rigid gas permeable (RGP) contact lenses. Remarkably, 96% of patients in the study were able to achieve a visual acuity of 0.3 logMAR or better with RGP lenses after the FL-MILK procedure, a vast improvement over their pre-operative vision. The researchers also found that the surgery did not negatively impact the comfort or safety of wearing RGP lenses long-term.
This breakthrough represents an important advancement in the management of keratoconus, a condition that affects thousands of people worldwide and can severely impact their quality of life. The FL-MILK procedure offers a promising new treatment option that can effectively control the progression of keratoconus and restore clear, comfortable vision for patients. Further research is needed to validate the long-term efficacy and safety of this innovative surgical approach.
Keratoconus | Cornea | Corneal transplantation | Contact lens
Understanding Keratoconus and Its Challenges
Keratoconus is a progressive eye condition that causes the cornea, the clear front part of the eye, to thin and bulge into a cone shape. This irregular corneal shape can lead to significant vision problems, including astigmatism, myopia, and even blindness if left untreated.
Keratoconus typically develops in adolescence and can worsen over time, making it a challenging condition to manage. Traditional treatments, such as corneal collagen cross-linking and corneal transplantation, have had limited success in controlling the progression of the disease and restoring clear vision.
Introducing the FL-MILK Procedure: A Breakthrough in Keratoconus Treatment
To address the limitations of existing treatments, a team of ophthalmologists developed a new surgical technique called femtosecond laser-assisted minimally invasive lamellar keratoplasty (FL-MILK). This innovative procedure aims to increase the thickness and flatten the curvature of the cornea, effectively controlling the progression of keratoconus.
The FL-MILK procedure involves implanting a thin corneal graft into the host corneal stroma through a small, 2.3 mm incision, without removing any corneal tissue. This approach helps to increase the overall thickness of the cornea and reshape its curvature, while minimizing the complications associated with traditional corneal transplant surgeries.
Fig. 2
Restoring Vision with Rigid Gas Permeable Contact Lenses
After the FL-MILK procedure, many keratoconus patients still experience some degree of irregular astigmatism, which can be effectively corrected using rigid gas permeable (RGP) contact lenses. These specialized lenses are designed to neutralize the irregular corneal shape, providing patients with clear and comfortable vision.
The researchers in this study closely examined the performance of RGP lenses in keratoconus patients who had undergone the FL-MILK surgery. They found that the customized RGP lenses fitted after the procedure were able to provide excellent visual acuity, with 96% of patients achieving a visual acuity of 0.3 logMAR or better. This was a significant improvement compared to their pre-operative vision.
Table 1 Comparison of corneal morphological data, uncorrected vision and endothelial count before and after FL-MILK (n = 27).
Ensuring Long-Term Safety and Comfort
One of the key concerns with using RGP lenses in keratoconus patients is the potential for adverse effects on the corneal health and comfort. However, the researchers found that the FL-MILK procedure did not negatively impact the long-term safety and comfort of RGP lens wear.
During the 2-year follow-up period, the researchers observed minimal complications, with only one patient experiencing temporary corneal epithelial staining due to lens scratches. The corneal endothelial cell density, tear film stability, and corneal sensitivity remained stable over time, indicating that the FL-MILK surgery did not compromise the overall health and function of the cornea.
Furthermore, the patients reported excellent comfort and satisfaction with their RGP lenses, with no significant differences compared to keratoconus patients who had not undergone the surgical procedure.
Implications and Future Directions
The findings of this study represent a significant advancement in the management of keratoconus, a condition that can severely impact the quality of life for thousands of people worldwide. The FL-MILK procedure offers a promising new treatment option that can effectively control the progression of the disease and restore clear, comfortable vision for patients.
By combining the corneal reshaping benefits of the FL-MILK surgery with the vision correction capabilities of RGP lenses, the researchers have developed a comprehensive approach to addressing the complex challenges of keratoconus. This approach has the potential to improve the long-term outcomes and quality of life for individuals living with this debilitating condition.
While further research is needed to validate the long-term efficacy and safety of the FL-MILK procedure, this study provides compelling evidence that this innovative surgical technique, coupled with the use of RGP lenses, can significantly enhance the visual rehabilitation of keratoconus patients. As the field of ophthalmology continues to evolve, advancements like the FL-MILK procedure offer hope for those struggling with the impact of keratoconus.
Author credit: This article is based on research by Ju Zhang, Xiao Lin, Zhenzhen Li, Xiaowei Zhong, Weiyun Shi, Xianli Du, Hua Gao.
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