Experience in Treatment of Patients with Keratoconus and Keratectasia

The aim of the investigation was to analyze experimental and clinical functional results of treatment of patients with keratoconus and secondary keratectasia using modern techniques.Materials and Methods. We carried out experimental researches on 15 eyes of experimental animals. The animals underwent corneal cross-linking according to Zurich protocol. We used laser radiation of 0.37 J. Further, on day 3 to 10, the animals were sacrificed, and we performed light and electron microscopy of the operated corneas.Clinical functional study was carried out on 108 eyes of 54 patients with primary keratoconus and secondary keratectasia.Conclusion. The findings suggest the following approach to treatment of patients with primary keratoconus and surgery-induced keratectasias:1) patients with I and II stages of primary keratoconus and stages I–III keratectasias — personalized cross-linking, and no earlier than 4 months later — implantation of intracorneal implants; after surgery — correction by soft contact lenses;2) stage III keratoconus patients — cross-linking according to Zurich protocol, with no guarantee of significant improvement of acuity of vision — implantation of stromal rings in 4 months; correction by soft contact lenses. A patient is to be warned of possible keratoplasty;3) in complicated III–IV stage keratoconus and secondary ectasia — planned penetrating keratoplasty.