Keratoconus

A noninflammatory, usually bilateral protrusion and thinning of the CORNEA, the apex being displaced downward and nasally. It occurs most commonly in females at about puberty. Two closely related noninflammatory corneal ectasias are pellucid marginal degeneration and keratoglobus.

Also Known As:

Networked: 4445 relevant articles (361 outcomes, 593 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Pathologic Dilatation (Ectasia)
2.	Astigmatism
3.	Refractive Errors (Refractive Error)
4.	Edema (Dropsy)
5.	Myopia

Experts

1.	Seitz, Berthold: 51 articles (09/2022 - 01/2002)
2.	Kymionis, George D: 49 articles (01/2022 - 01/2005)
3.	Hafezi, Farhad: 39 articles (06/2022 - 10/2006)
4.	Feizi, Sepehr: 36 articles (01/2021 - 01/2009)
5.	Shetty, Rohit: 35 articles (05/2022 - 03/2009)
6.	McGhee, Charles N J: 33 articles (06/2022 - 03/2002)
7.	Langenbucher, Achim: 32 articles (09/2022 - 01/2002)
8.	Jhanji, Vishal: 31 articles (10/2022 - 03/2008)
9.	Hashemi, Hassan: 29 articles (06/2022 - 11/2007)
10.	Javadi, Mohammad Ali: 26 articles (01/2021 - 11/2005)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Keratoconus:

1.	CollagenIBA 07/01/2018 - "Standard epi-off corneal collagen crosslinking is safe and effective to halt the progression of the keratoconus with significant improvement in the best-corrected visual acuity at 3-year follow-up." 01/01/2019 - "The aim of this study was to evaluate the safety and efficacy of collagen cross-linking (CXL) in advanced progressive keratoconus with a maximum keratometry (Kmax) value of more than 58 diopters (D). " 08/01/2013 - "Collagen cross-linking has been reported to be effective in treating progressive keratoconus, and this study aims to evaluate the long-term efficacy of this procedure. " 09/01/2010 - "The results of this study indicate that collagen cross-linking appears to be an effective therapeutic option for progressing keratoconus. " 02/01/2009 - "The results of this study indicate that collagen cross-linking appears to be an effective therapeutic option for progressing keratoconus. "
2.	Riboflavin (Vitamin B2)FDA LinkGeneric 03/01/2012 - "The study demonstrated significant and rapid functional improvement in pediatric patients younger than 18 years with progressive keratoconus, undergoing riboflavin-UVA–induced cross-linking. " 01/01/2017 - "I-CXL using 0.1% riboflavin halts keratoconus progression within 24mo, resulting in a significant improvement in visual and topographic parameters. " 03/11/2019 - "Retention ring-assisted continuous application of riboflavin for 10 minutes in pulsed-light accelerated cross-linking is a comparably safe and effective treatment for halting the progression of keratoconus in 12 months when compared to outcomes of the standard Dresden protocol shown in previous reports." 05/01/2013 - "CXL with riboflavin and UV-A improved CS and inhibited the progression of keratoconus. " 03/01/2023 - "The objective of this study was to compare the effectiveness and safety of short versus standard riboflavin induction times in cross-linking (CXL) for keratoconus. "
3.	SolutionsIBA 05/01/2021 - "The results show the great potential of the ocular developed solution for their use in transepithelial cross-linking for keratoconus treatment." 05/01/2021 - "The surgical technique offers a unique solution to treat keratoconus. " 04/11/2021 - "It is hoped that this article can provide guidance for the rational selection of an optimal clinical solution to keratoconus. " 11/01/1999 - "Corneal buttons were obtained from 7 keratoconus patients and stored in a preserving solution for 7-60 days (average, 32.4 days) before use. " 12/01/1999 - "Moreover, despite improvement in the postoperative spherical equivalent and uncorrected visual acuity in most cases, the risk of loss of BCVA and the necessity of performing PKP in 3 cases lead us not to consider LASIK as a primary solution for keratoconus."
4.	HydrogelsIBA 01/01/2020 - "Wearing hydrogel CLs, rigid gas permeable CLs, and special designs for irregular corneas in keratoconus patients (CLs with keratoconic design, hybrid CLs, piggyback fit, and scleral CLs) have been reported to alter the concentration of several molecules in tears. " 10/01/2007 - "We report a case of corneal warpage secondary to hydrogel lens wear that was initially mistaken as a case of keratoconus. " 10/01/2007 - "Mistaken diagnosis of keratoconus because of corneal warpage induced by hydrogel lens wear." 12/01/2020 - "Soft lenses showed good efficacy for the treatment of mild-to-moderate keratoconus with newer designs improving visual performance such as customised hydrogel and novel pinhole lenses. " 01/01/2016 - "Twelve eyes of 7 patients with keratoconus were treated at our institution by the same surgeon with femtosecond laser-assisted ICRS implantation followed by slit-incision closure with a hydrogel ocular sealant. "
5.	Oxygen (Dioxygen)IBA 09/01/2022 - "We included studies that reported increased oxygen availability during CXL in patients with keratoconus published within the last 10 years. " 06/01/2021 - "To investigate the potential additive effect of systemic supplemental oxygen administered during accelerated corneal crosslinking (CXL) for progressive keratoconus (KC). " 12/01/2020 - "To evaluate the outcomes of customized corneal crosslinking (CXL) for treatment of progressive keratoconus (KC) using a transepithelial approach with supplemental oxygen. " 12/01/2020 - "Customized corneal crosslinking for treatment of progressive keratoconus: Clinical and OCT outcomes using a transepithelial approach with supplemental oxygen." 01/01/2011 - "[Advantage of higher oxygen transmissibility material Piggyback lens for keratoconus correction]."
6.	SiliconesIBA 10/01/1984 - "Aspheric silicone lenses for keratoconus." 07/01/2003 - "After a follow-up period of 4 months, visual acuity increased to 0.70 with a correction of +0.75 sphere -2.5 cylinder/84 degrees in Patient 1; after a follow-up period of 6 months, visual acuity increased to 0.60 with a correction of +1.0 -2.0/90 degrees in Patient 2. Foldable toric silicone IOL may be a surgical option in the management of regular marked corneal astigmatism caused by keratoconus." 01/01/2023 - "Silicone hydrogel CL-assisted CXL seems as effective as A-CXL in halting keratoconus progression in thin corneas with no side effects during the one-year follow-up period." 10/01/2015 - "Fitting custom-made hydrogel silicone CL in keratoconus with ICRS is a feasible treatment with low rate of complications and adequate visual acuity and WT." 01/01/2023 - "The aim of this study was to evaluate the efficacy of a new-generation hybrid contact lens for improving visual outcomes and vision-related quality-of-life performance in patients with keratoconus who had intolerance or treatment failure of conventional correction methods such as the use of soft silicone-hydrogel or rigid gas-permeable contact lenses. "
7.	Dextrans (Dextran)FDA Link 06/01/2014 - "A 24-year-old woman with bilateral keratoconus underwent a corneal de-epithelization and subsequently CXL in the right eye, which was performed with the application of 0.1% riboflavin with 20% dextran, and exposure to ultraviolet-A light (370 nm, 2.9-3.1 mW/cm) for 30 minutes. " 01/01/2014 - "According to our clinical and in-vivo micro-morphological results the technique results safe, and efficacious in stabilizing progressive keratoconus and may be considered a valid option in the treatment of thin ectatic corneas alone or in combination with hypoosmolar or dextran-free riboflavin solutions. " 06/01/2012 - "Seven patients who had their progressive keratoconus documented underwent corneal deepithelization and subsequently CXL, which was performed with the application of 0.1% riboflavin with 20% dextran, and exposure to UVA light (370 nm, 2.9-3.1 mW/cm(2)) for 30 minutes. " 01/01/1983 - "Influence of dextran macromolecules on the glycosaminoglycan metabolism of cultured corneal stroma and keratoconus fibroblast." 02/01/2020 - "To determine 2-year efficacy of accelerated corneal cross-linking (CXL) in keratoconus treatment using standard riboflavin-dextran or hypotonic riboflavin solutions. "
8.	Mitomycin (Mitomycin-C)FDA LinkGeneric 09/01/2021 - "To report a case of a 20-year-old woman who developed massive and progressive corneal remodeling in both eyes after bilateral PRK with mitomycin and CXL as an elective refractive procedure for mild keratoconus. " 10/01/2011 - "Consecutive patients who had PRK augmented with topical mitomycin-C (MMC) after PKP for keratoconus were retrospectively reviewed. " 01/01/2022 - "To evaluate the effectiveness of combined photorefractive keratectomy (PRK) with mitomycin-C (MMC) application and CXL in the management of grade 1-2 keratoconus over a 2-year follow-up. " 02/01/2021 - "To evaluate and compare corneal haze as determined by optical coherence tomography (OCT) after corneal cross-linking (CXL) for the treatment of mild to moderate keratoconus with or without mitomycin C (MMC) application. " 02/01/2021 - "Mitomycin C Application After Corneal Cross-linking for Keratoconus Increases Stromal Haze."
9.	Biomarkers (Surrogate Marker)IBA 01/01/2016 - "This review discusses the importance of tear fluid as a source of biomarker for keratoconus and how advances in technology have helped map the complexity of tears and thereby molecular readouts of the disease. " 10/01/2021 - "This study aimed to investigate the metabolite differences between patients with keratoconus and control subjects and identify potential serum biomarkers for keratoconus using a non-targeted metabolomics approach. " 11/15/2023 - "It was highly correlated with CBI (r = -0.69; P < 0.001); however, the kc parameter had greater specificity (94%) than CBI (75%), whereas the 2 biomarkers had similar area under the curve (0.98 vs. 0.94) and sensitivity (96% vs. 92%) in predicting the occurrence of keratoconus. " 11/15/2023 - "Accuracy of an Air-Puff Dynamic Tonometry Biomarker to Discriminate the Corneal Biomechanical Response in Patients With Keratoconus." 04/28/2023 - "To determine the prevalence of keratoconus in Shiraz University of Medical Sciences Employees and the related risk factors including oxidative stress biomarkers. "
10.	4-hexyloxyaniline (HOA)IBA 01/01/2021 - "This study analyzes the relationship between contrast-sensitivity and higher-order aberrations (HOA) in mild and subclinical-keratoconus in subjects with good visual-acuity (VA). " 10/01/2017 - "According to our study, SRI, SAI, EDP, EDD values, and HOA other than spherical aberration were higher in the clinically and topographically normal fellow eyes of unilateral keratoconus patients when compared to a control group. " 09/01/2017 - "This study aims to investigate the long-term effect of CXL on ocular HOA in patients with progressive keratoconus (KC). " 01/01/2021 - "This suggests that the main mechanism underlying the decreased vision quality in keratoconus is the increase of HOA." 01/01/2021 - "HOA and contrast-sensitivity are inversely correlated in subjects with mild keratoconus despite good VA. "

Therapies and Procedures

1.	Corneal Cross-Linking 10/01/2023 - "Customised peripheral corneal cross-linking (P-CXL) treated very severe keratoconus with a success rate of 85.7% and improved visual acuity and tomographic indicators in most cases. " 12/01/2015 - "Corneal cross-linking can halt the progression of keratoconus, but what is the best approach for treatment? " 10/03/2021 - "Background: Corneal collagen cross-linking (CXL) has recently become the preferred practice in the management of progressive keratoconus and other corneal ectasias as it has been proven to be successful in halting progression of the disease with an excellent safety and efficacy profile. " 08/01/2021 - "Deep learning of the As-OCT color-coded maps effectively discriminates progressive keratoconus from non-progressive keratoconus with an accuracy of approximately 85% using the adjusted age algorithm, indicating that it will become an aid for predicting the progression of the disease, which is clinically beneficial for decision-making of the surgical indication of corneal cross-linking (CXL)." 02/01/2012 - "Transepithelial CXL treatment appeared to halt keratoconus progression, with a statistically significant improvement in visual and topographic parameters. "
2.	Contact Lenses 09/01/2011 - "In 69% patients after PKP non-corrected visual acuity (NCVA) was 0.1 or more and mean best corrected visual acuity (BCVA) was 0.63, that is similar to efficacy of contact lens correction in stage III-IV keratoconus. " 12/01/2006 - "The modified ALTK procedure effectively treated a patient with moderate keratoconus with a best-corrected visual acuity of 20/80, despite rigid gas-permeable contact lenses. " 11/01/2011 - "While no significant measurable differences in K- and E-values were observed, fitting of a pancorneal toric RGP contact lens in keratoconus led to a marked improvement in visual acuity and a visible change in corneal compression." 12/01/2002 - "In the model-building study, the CTI in keratoconus patients (1.28 +/- 0.15) was significantly greater than in contact lens-wearing (1.10 +/- 0.03; P < 0.001) and normal eyes (1.09 +/- 0.04; P < 0.001). " 06/01/2023 - "Keratoconus and control eyes demonstrated high repeatability and reproducibility when using CSP measurements, which may prove helpful in fitting contact lenses."
3.	Corneal Transplantation (Keratoplasty) 01/01/2023 - "Both techniques of corneal transplantation led to a significant improvement in the visual and refractive variables in eyes with advanced keratoconus. " 01/01/2019 - "This technique of corneal transplantation is more effective in eyes with severe keratoconus compared with those with moderate keratoconus." 09/01/2015 - "Traditionally, the mainstay of treatment for advanced keratoconus (KC) has been either penetrating or deep anterior lamellar keratoplasty (PK or DALK, respectively). " 05/01/2011 - "Deep anterior lamellar keratoplasty that uses the big-bubble technique is effective in patients with keratoconus. " 10/01/2010 - "Topography-guided conductive keratoplasty may be effective in reshaping corneal configuration in eyes with keratoconus, without serious complications, and possibly contributed to avoiding or delaying corneal transplantation."
4.	Lasers (Laser) 01/01/2019 - "Although the long-term safety and efficacy of femtosecond laser-assisted ICRS implantation accompanied or followed by TE-ACXL in children with keratoconus and VKC is high, some cases still may need repeat cross-linking." 01/01/2019 - "Implantation of a 355-degree intracorneal keraring using femtosecond laser improved the visual, refractive, and topographic parameters in keratoconus patients, with a high rate of ICR extrusion and instability. " 01/01/2016 - "Keraring ICRS insertion assisted by femtosecond laser and corneal CXL provided significant improvement in visual acuity, spherical equivalent, and keratometry, which suggests that it may be effective, safe, and predictable for keratoconus correction." 02/01/2007 - "The use of single Intacs with femtosecond laser to treat superior pellucid marginal corneal degeneration improved visual acuity." 09/01/2008 - "Intacs treatment with a femtosecond laser was effective for management of keratoconus of all stages. "
5.	Penetrating Keratoplasty 05/01/1992 - "The purpose of this study was to establish the mean and range of axial length among both keratoconus eyes with no previous surgery and postkeratoplasty keratoconus eyes, and to determine if there is a significant reduction of axial length following variations in surgical techniques in penetrating keratoplasty. " 11/01/2017 - " being considered a high-risk procedure in children, penetrating keratoplasty can achieve good results, especially in patients with keratoconus. " 10/01/2018 - "Still, penetrating keratoplasty is the gold standard of surgical treatment for end-stage keratoconus, whereas recently lamellar procedures have gained higher importance. " 02/01/2012 - "This ICRS is an effective treatment for managing keratoconus and might delay or even avoid the need for penetrating keratoplasty." 11/01/2002 - "This study was designed to identify factors that may help to determine the likelihood of a patient with keratoconus undergoing a penetrating keratoplasty (PK) after referral to a cornea service. "