Surgical treatment of keratoconus at the turn of the 20th century.

Abstract

This paper reviews surgical modalities for treatment of keratoconus at the threshold of the 20th century. All ophthalmic literature from 1895 until 1925 in English and German, available at the library of the Institute of Ophthalmology, London, United Kingdom, was studied with respect to this topic. Three thermal procedures were described; galvanocauterization with perforation, without perforation, and a non-contact application of heat to the corneal apex. Radial extension of a thermal burn to correct the minus cylinder represented a further modification. Excision of the conical area was suggested either as a lamellar dissection or as a full thickness trephination. Incision of the cone appeared to be less popular. In staged procedures, a combination of galvanocauterization, splitting of the cornea, conjunctival flap, and a subsequent optical iridectomy were applied. The treatment of keratoconus 100 years ago used refractive surgery to improve visual function by modifying corneal shape.