The risk of disease transmission removes a sizable portion of corneal donor tissue from the possibility of surgical use. Physicians, eye bank leaders, and health-related organizations share responsibility for monitoring and updating standards to address new threats, such as Zika virus.
Isolated Bowman layer transplantation can reduce and stabilize corneal ectasia in eyes with progressive advanced keratoconus, researchers said. “It flattens the cornea into a more normal position,” said Jack Parker, MD, a researcher at the Netherlands Institute for Innovative Ocular Surgery (NIIOS) in Rotterdam, The Netherlands. “It doesn’t give them perfect vision, but it keeps them from getting worse. It lets them to continue wearing their contact lenses.”
The promise of simple, objective, single instrument-based screening for highly asymmetric keratoconus in patients considering LASIK is still more of an idea than reality. Multiple metrics can identify early keratoconus in a minority of affected eyes, but none of the metrics consistently identify early corneal abnormalities and none of the metrics identify the same eyes as being at elevated risk for ectatic disease.
In this column, I will describe various keratoconus case scenarios from my referral-based practice—ranging from the highly complex to simple—that can be improved with single or staged techniques that move patients toward emmetropia.