In this first of a two-part series, Arun C. Gulani, MD, MS, explains how approaching keratoconus as a refractive surgery will change the way both ophthalmologists and patients will approach this condition to bring in a new era of not only relieving but also enhancing the lifestyle of this patient population. In Part 2, Dr. Gulani will share strategies and cases of patients with keratoconus with different case scenarios in action.
A U.S. patent was granted to Gholam A. Peyman, MD, in June 1989 for a method of modifying the corneal curvature of the eye. The surgical procedure involved cutting a flap in the cornea, pulling the flap back to expose the corneal bed, ablating the exposed surface and then replacing the flap. The current procedure of laser assisted in-situ keratomileusis (LASIK) was not FDA approved until 1999.
The femtosecond laser has brought many significant advances to eye surgery. For more than a decade, it has been used to create lamellar corneal flaps for laser in situ keratomileusis (LASIK), and more recently this laser is used to precisely perform several steps in cataract surgery.
After much anticipation and a long wait for both clinicians and patients in need, the U.S. Food and Drug Administration (FDA) approved corneal cross-linking (CXL) in mid April. This procedure is globally considered the only method of halting the progressive family of diseases called corneal ectasias, including keratoconus.