Seyed Javad Hashemian, an eye specialist, a specialist in corneal transplantation and refractive surgery, said in an interview with a reporter from the Clinical Department of the Journalists Club Medical Scientific Group about corneal ectasia: “Ectaxia or corneal hump is characterized by progressive changes in refractive errors, meaning the patient becomes nearsighted and his glasses number increases every 3 to 6 months and he suffers from astigmatism and decreased vision; these complications are caused by the cornea protruding forward and corneal ectasia, which usually occurs during puberty.”
He said: The incidence of keratoconus in families with a history of this disease is several times higher than in others; this disease affects both eyes asymmetrically, meaning one eye is more affected and the other less; keratoconus can occur along with other diseases, the most common of which is “etopye” or an allergic background in the family such as spring allergies, asthma, hives, and chromosomal disorders such as Down syndrome; those who suffer from these problems should definitely be examined in adulthood in terms of eye health and keratoconus.
This specialist in corneal transplantation and refractive surgery continued: “One of the factors that causes and progresses this disease is prolonged eye rubbing. This disease is more prevalent in Middle Eastern countries, especially Iran, which has a hot and dry climate, and in cold and dry areas and allergy-prone areas.”
Hashemian said: “Keronecrosis is a disorder in the structure of the cornea that can occur due to genetics, atopy, or prolonged rubbing. Due to the loose consistency of the cornea and the pressure exerted on a point or part of the cornea from inside the eye, that part becomes prominent, resulting in the surface of the cornea becoming irregular and causing astigmatism.”
A strategy to prevent progressive changes in keratoconus
He explained about the ways to prevent keratoconus: The most important preventive method of keratoconus that is being discussed today is to strengthen the cornea with the help of “cross-linking” as soon as it is diagnosed under the age of 20. In this method, we pour vitamin B2 riboflavin into the cornea for 20 to 30 minutes, then we shine ultraviolet objects at a specific dose on the cornea for 10 to 30 minutes using different methods. New protein bonds in the collagen fibers of the cornea and at the cellular level of the cornea create structural changes that cause Strengthens the consistency of the cornea . It increases the resistance of the cornea and prevents further progressive changes; therefore, if this procedure is performed on time and in the early stages, it will stop the disease and there will be no worries in the future, but if it is not performed on time, it will lead to decreased vision and ultimately a corneal transplant.
Hashemian stated: “The most important characteristic of keratoconus in adulthood is a progressive decrease in vision, myopia, and astigmatism. As the disease progresses, because the astigmatism is irregular, despite the use of glasses, the patient’s vision is not fully corrected and he does not have sufficient vision.”
Methods for early detection of keratoconus
He said: “Keratoconus can be diagnosed in the early stages based on visual assessment or corneal topography, examining the thickness of the cornea from the center to the periphery with Orb Scan, Pentacam, or OCT devices.”
This specialist in corneal transplantation and refractive surgery continued: “The way to treat keratoconus as soon as it is diagnosed is to prevent its progression and correct vision, which in the early stages includes prescribing glasses, prescribing contact lenses such as soft contact lenses in the early stages and hard contact lenses in the advanced stages, new hybrid lenses, and scleral lenses. If the disease is not controlled with these measures or the patient is unwilling to wear hard lenses, the next method is to change the shape of the cornea and reconstruct the shape of the cornea, which can be done well today by using rings or rings in the thickness of the cornea with the help of a femtosecond laser with femtosecond laser technology to rearrange the shape and curve of the cornea. With these measures, the patient can find good and sufficient vision with glasses or contact lenses.”
Hashemian stated: “If glasses are needed to correct vision and the patient does not want to wear glasses, new intraocular lenses such as ICL and Toricon can be used, which are very effective in improving the vision of these people; if the patient does not visit a doctor and the disease progresses and causes corneal scarring or severe vision loss, the final procedure is a corneal transplant, which is performed in layers, and patients who are candidates for this procedure should not worry.”