Management of keratoconus: an updated review

Frontiers in Medicine

Medicine

Ankur Barua¹  Darren Shu Jeng Ting²  Jorge L. Alió del Barrio³  Renato Ambrósio⁴  Rashmi Deshmukh⁵  Zun Zheng Ong⁶  Dalia G. Said⁷  Harminder S. Dua⁷  Radhika Rampat⁸  Marcus Ang⁹  Jodhbir S. Mehta⁹ 

[1] Birmingham and Midland Eye Centre, Birmingham, United Kingdom;Birmingham and Midland Eye Centre, Birmingham, United Kingdom;Academic Ophthalmology, School of Medicine, University of Nottingham, Nottingham, United Kingdom;Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom;Cornea, Cataract and Refractive Surgery Unit, Vissum (Miranza Group), Alicante, Spain;Division of Ophthalmology, School of Medicine, Universidad Miguel Hernández, Alicante, Spain;Department of Cornea and Refractive Surgery, Instituto de Olhos Renato Ambrósio, Rio de Janeiro, Brazil;Department of Ophthalmology, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil;Federal University of São Paulo (UNIFESP), São Paulo, Brazil;Department of Cornea and Refractive Surgery, LV Prasad Eye Institute, Hyderabad, India;Department of Ophthalmology, Queen’s Medical Centre, Nottingham, United Kingdom;Department of Ophthalmology, Queen’s Medical Centre, Nottingham, United Kingdom;Academic Ophthalmology, School of Medicine, University of Nottingham, Nottingham, United Kingdom;Department of Ophthalmology, Royal Free London NHS Foundation Trust, London, United Kingdom;Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore;

关键词: artificial intelligence;    refractive surgery;    contact lens;    cornea;    corneal cross-linking;    corneal transplant;    intracorneal ring segment;    keratoconus;   

DOI  :  10.3389/fmed.2023.1212314

 received in 2023-04-26, accepted in 2023-05-30,  发布年份 2023

来源: Frontiers

【 摘 要 】

Keratoconus is the most common corneal ectatic disorder. It is characterized by progressive corneal thinning with resultant irregular astigmatism and myopia. Its prevalence has been estimated at 1:375 to 1:2,000 people globally, with a considerably higher rate in the younger populations. Over the past two decades, there was a paradigm shift in the management of keratoconus. The treatment has expanded significantly from conservative management (e.g., spectacles and contact lenses wear) and penetrating keratoplasty to many other therapeutic and refractive modalities, including corneal cross-linking (with various protocols/techniques), combined CXL-keratorefractive surgeries, intracorneal ring segments, anterior lamellar keratoplasty, and more recently, Bowman’s layer transplantation, stromal keratophakia, and stromal regeneration. Several recent large genome-wide association studies (GWAS) have identified important genetic mutations relevant to keratoconus, facilitating the development of potential gene therapy targeting keratoconus and halting the disease progression. In addition, attempts have been made to leverage the power of artificial intelligence-assisted algorithms in enabling earlier detection and progression prediction in keratoconus. In this review, we provide a comprehensive overview of the current and emerging treatment of keratoconus and propose a treatment algorithm for systematically guiding the management of this common clinical entity.

【 授权许可】

Unknown   
Copyright © 2023 Deshmukh, Ong, Rampat, Alió del Barrio, Barua, Ang, Mehta, Said, Dua, Ambrósio and Ting.