Update on keratoconus diagnosis and treatment

Abstract

AbstractThe diagnosis of keratoconus has changed revolutionary during the past years. With the appearance of 3D corneal tomography and OCT devices even subclinical forms of the disease can be detected. Similarly, a wide range of interventions has been introduced in the treatment modalities as well. Earlier, nearly only rigid gas permeable contact lens and penetrating keratoplasty were the solutions. Nowadays, either conventional epithelium‐off or epithelium‐on collagen cross‐linking (CXL) treatment targets the cause of the disease. Intracorneal ring segments, toric IOLs, and keratorefractive procedures are also available sometimes in combination with CXL to treat certain forms of the disease. Surgical treatment shifted to deep anterior lamellar keratoplasty, which preserves the integrity of the globe. Postoperative immune rejection is less frequent, endothelial cell count reduction is less as compared to penetrating keratoplasty. Corneal hydrops, a special form of the disease usually requires conservative treatment and after the healing process surgery can be performed if necessary.