Management of keratoconus in Moorfields Eye Hospital

Abstract

In a retrospective analysis of 88 new patients with a five year follow up who presented with keratoconus, contact lenses, particulary hard corneal lenses, provided the major contribution to the management of early and moderate keratoconus with an immediate improvement of up to 7 lines of Suellen visual acuity at diagnosis. Satisfactory contact lens tolerance has been achievedby improving wetting, stability and gas permeability factors, and with a steady shift towards the use of well tolerated contact lenses, visual acuity can be maintained at a satisfactory standard over several years. 88.6% of these eyes analysed retained a best acuity of 6/12 or better at five years. Moderate and severe complications of contact lens wear were rare although progressive loss of lens tolerance was a signifcant problem. Of those patients with severe keratoconus, 11.5% required penetrating keratoplasty. The results of this surgically managed group were good with 14 out of 20 eyes (70%) achieving a best corrected acuity of 6/6 or better and 19 (95%) achieving 6/12 or better.