What is keratoconus?
For patients who have keratoconus or other forms of corneal ectatic disease, their vision progressively declines due to deformation of their cornea. Regular glasses and contacts are often found to be unhelpful and the patients need to use Rigid Gas Permeable (hard) contact lenses. When patients become intolerant to these special contacts or their vision is not good with these contact lenses due to advanced disease, our Long Island corneal surgeons at the Northwell Department of Ophthalmology offer the following:
Types of treatment
- PROSE Lens
- DEEP ANTERIOR LAMELLAR KERATOPLASTY (DALK)
- PENETRATING KERATOPLASTY
- CORNEAL COLLAGEN CROSS-LINKING
Intacs are plastic segments implanted into the corneal stroma in order to “girdle up” or support the cornea which is bulging inferiorly. Dr. Carolyn Shih only uses the bladeless Intralase laser to make the tracks for the Intacs in order to obtain the most accurate, safest results. The Intacs’ purpose is to help improve the quality of vision with contact lenses or glasses. For more information about Intacs or to schedule a consult please call (516) 470-2022.
The Ocular Surface Center at Northwell has a PROSE specialist, Dr. Corina Busuioc who has been trained to fit specialty contact lenses on patients who have advanced keratoconus or ocular surface disease. This innovative technology allows patients to see better if they don’t have a large central scar. For a consultation for Rigid gas permeable contact lenses or the PROSE lens, please call (516) 470-2020
For patients with corneal scarring either due to keratoconus or from previous infection or trauma, the patient may be a candidate for DALK – a form of corneal transplant that selectively removes the layers of the cornea that encompass the scar. The innermost layer, the pump layer, is left in place in attempt to maintain the structural integrity of the patient’s eye postoperatively in case the eye suffers blunt force trauma. The technically challenging procedure is also performed because it is thought to have less rejection than a full-thickness transplant or Penetrating Keratoplasty (PK). Postoperatively sutures are selectively removed over the subsequent months to optimize the shape of the cornea. Once the shape is optimized, glasses or hard contact lenses are prescribed. For an evaluation with Dr. Carolyn Shih and Dr. Jules Winokur regarding DALK, please call us at (516)470-2020 or (212) 702-7620.
This is the traditional form of corneal transplantation which removes all layers of the cornea using a precise circular trephine and replaces it with a new donor cornea. This is an outpatient procedure usually done under local anesthesia at Syosset Hospital or Manhattan Eye, Ear and Throat Hospital (MEETH). This form of transplant is reserved for patients who have had corneal scarring from trauma, keratoconus, or severe corneal edema which has remained untreated for many years. Because it requires so many sutures, visual recovery may take months to a year as our Long Island corneal surgeons selectively remove sutures to optimize vision over time. When the cornea is at its optimal shape, the patient may then receive a pair of glasses or sometimes contact lenses for their best quality vision. For an evaluation with our Long Island corneal surgeons who perform Penetrating Keratoplasty, Drs. Udell, Shih, Steiner, please call us at (516)470-2020 or to reach Dr. Amilia Schrier or Dr. Jules Winokur, please call us at (212) 702-7300 or (212) 702-7620.
The Northwell Department of Ophthalmology was selected to be part of a nationwide Avedro cross-linking trial to treat Keratoconus. Corneal collagen cross-linking is a treatment whose aim is to strengthen the collagen bonds in weakened corneas such as those in patients who have Keratoconus or post-refractive surgery ectasia. While this is not considered a cure for corneal ectasia patients, this treatment is thought to perhaps slow the progression of the disease and hopefully to strengthen the cornea. Studies internationally have shown that there is some flattening effect on these corneas with improvement in vision. For more information about this treatment or to schedule a corneal evaluation please call (516)470-2020.