Keratoconus Alternative Treatment

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"No LASIK or PRK for me....I just found out that I have Keratoconus." - Cathy Brandon

Have you been turned away from LASIK or PRK because the doctor diagnosed you with keratoconus? Many people have and think that they would never be free of contacts or glasses. Unfortunately they are unaware that there are treatments for keratoconus as well as options to correct myopia that maybe better than LASIK or PRK for their eyes.

What's Keratoconus Anyway?

According to WebMD, keratoconus is a condition of the eye in which the structure of the cornea (the clear outer part of the eye) is not strong enough to hold its round shape, causing it to bulge outwards like a cone.

Often, this condition is hereditary and occurs more frequently in people with certain medical problems. Progression of the outward corneal bulging can happen very quickly or can occur over several years, though these changes can stop at any time.

How Will Keratoconus Affect My Vision?

Keratoconus will change vision in two ways:
  • Irregular astigmatism results as the smooth surface of the cornea becomes slightly wavy
  • Nearsightedness develops as the front of the cornea expands
  • Sudden change of vision in just one eye
  • Double vision in just one eye
  • Bright lights with halos around them
  • Light streaking
  • Seeing triple ghost images

Why Can't I Have LASIK?

For those with keratoconus who wanted to be free of their glasses or contact lenses, it is probably disheartening to find out that LASIK or PRK can be very dangerous for even a small degree of keratoconus.

The reason is that these two procedure remove tissue from the cornea in order to reshape it to the desired curvature which would further weaken the structural integrity of the cornea and worsen the progression of keratoconus.

How is Keratoconus Treated?

  1. Corneal transplant (keratoplasty) - this involves removing the center of the cornea and replacing it with a donor cornea that is stitched into place.
  2. Corneal inserts (intacs or intracorneal ring segments) - this involves inserting two tiny, clear, crescent shaped plastic inserts to flatten the cone shape of the cornea.
  3. Collagen Cross-Linking - riboflavin drops are applied to the cornea and exposed to the UVA light. The procedure strengthens the cornea to prevent further thinning or bulging.

How is the Nearsightedness Caused by Keratoconus Treated?

  1. Eyeglasses - for mild cases, eyeglasses can usually make vision clear again.
  2. Contact lenses - rigid gas permeable contact lenses help mask the underlying irregular cornea. However, overtime, the eyes may grow to be contact lens intolerant.
  3. Implantable Lenses - Visian ICL, a flexible gel-like lens which is surgically implanted into the eye, has been used by surgeons to correct moderate to severe myopia once the keratoconus has been stablized. This is a great option for those who were turned away from LASIK or PRK since no eye tissue removal is necessary during the Visian ICL procedure. Olympic gold medalist Steve Holcomb got the Visian ICLs after his keratoconus was stablized using the collagen cross-linking method.

For those who have are looking for freedom from glasses and contacts, contact a qualified Visian ICL doctor today to learn about your options!

Important Safety Information

The Visian ICL is intended for the correction of moderate to high nearsightedness. Visian ICL and Visian TICL surgery is intended to safely and effectively correct nearsightedness between -3.0 D to -15.0 D, the reduction in nearsightedness up to -20.0 D and treatment of astigmatism from 1.0 D to 4.0 D. If you have nearsightedness within these ranges, Visian ICL surgery may improve your distance vision without eyeglasses or contact lenses. Because the Visian ICL corrects for distance vision, it does not eliminate the need for reading glasses, you may require them at some point, even if you have never worn them before.

Implantation of the Visian ICL is a surgical procedure, and as such, carries potentially serious risks. Please discuss the risks with your eye care professional. Complications, although rare, may include need for additional surgical procedures, inflammation, loss of cells from the back surface of the cornea, increase in eye pressure, and cataracts.

You should NOT have Visian ICL surgery if:

  • Your doctor determines that the shape of your eye is not an appropriate fit for the Visian ICL
  • You are pregnant or nursing
  • You do not meet the minimum endothelial cell density for your age at the time of implantation as determined by your eye doctor
  • Your vision is not stable as determined by your eye doctor

Before considering Visian ICL surgery you should have a complete eye examination and talk with your eye care professional about Visian ICL surgery, especially the potential benefits, risks, and complications. You should discuss the time needed for healing after surgery. For additional information with potential benefits, risks and complications please visit



1Visian ICL Patient Information Booklet

2Sanders D. Vukich JA. Comparison of implantable collamer lens (ICL) and laser-assisted in situ keratomileusis (LASIK) for Low Myopia. Cornea. 2006 Dec; 25(10):1139-46.

3Naves, J.S. Carracedo, G. Cacho-Babillo, I. Diadenosine Nucleotid Measurements as Dry-Eye Score in Patients After LASIK and ICL Surgery. Presented at American Society of Cataract and Refractive Surgery (ASCRS) 2012.

4Shoja, MR. Besharati, MR. Dry eye after LASIK for myopia: Incidence and risk factors. European Journal of Ophthalmology. 2007; 17(1): pp. 1-6.

5Lee, Jae Bum et al. Comparison of tear secretion and tear film instability after photorefractive keratectomy and laser in situ keratomileusis. Journal of Cataract & Refractive Surgery , Volume 26 , Issue 9 , 1326 - 1331.

6Parkhurst, G. Psolka, M. Kezirian, G. Phakic intraocular lens implantantion in United States military warfighters: A retrospective analysis of early clinical outcomes of the Visian ICL. J Refract Surg. 2011;27(7):473-481.

*American Refractive Surgery Council

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