Keratoconus: Diagnosis and Treatment

298 Pages·2022·21.026 MB·English

by  Sujata Das

Keratoconus
Diagnosis and Treatment
Sujata Das
Editor
123
Keratoconus
Sujata Das
Editor
Keratoconus
Diagnosis and Treatment
Editor
Sujata Das
L V Prasad Eye Institute
Bhubaneswar, Odisha, India
ISBN 978-981-19-4261-7 ISBN 978-981-19-4262-4 (eBook)
https://doi.org/10.1007/978-981-19-4262-4
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Foreword
The problem of keratoconus is gaining increasing attention all over the world
as the newer diagnostic approaches made it possible to recognize this entity
earlier and better. This is now considered the most common ectatic disorder
of the cornea. Multiple factors contribute to the causation of keratoconus—
genetic, mechanical, and other factors.
The management of this problem has several options ranging from simple
optical correction in the early stages to a variety of surgical procedures in the
later stages, usually with high degree of success.
Dr Sujata Das is a very experienced and accomplished clinician with spe-
cial interest in keratoconus. Other contributing authors are all very well-
known corneal specialists with excellent record of publishing. This book has
benefitted immensely from this pool of talent and hence provided a compre-
hensive coverage of this topic.
I congratulate the authors on this effort and recommend this volume to all
those who wish to get more information on keratoconus from a single source.
L V Prasad Eye Institute, Gullapalli N. Rao
L V Prasad Marg, Banjara Hills
Hyderabad, Telangana, India
v
Foreword

It is a great honor that I have been given the privilege to write the foreword
for the book Keratoconus edited by Sujata Das.
Dr Das is actively involved in cornea and anterior segment disorders,
including keratoconus, corneal infections, and eye banking. She is one of the
leaders in the field, who has received numerous awards such as the Developing
Country Eye Researcher Award from the Association for Research in Vision
and Ophthalmology Foundation and the Achievement Award from the
American Academy of Ophthalmology.
Keratoconus is a classic disease that has been known for a long time, and it
is relatively common among corneal diseases. However, the cause of keratoco-
nus has not yet been determined, and the diagnosis and treatment of keratoco-
nus have changed with time. In the past, keratoconus was a non-inflammatory
corneal thinning disorder and the only way to control its progression was to let
it grow naturally, but now keratoconus is considered to be a chronic inflamma-
tory disease whose progression can be suppressed. The paradigm shift in kera-
toconus care requires eye care specialists to be up to date.
The book comprises 23 chapters, with the topics ranging from public
health and epidemiology to the newer paradigms in diagnosis and manage-
ment. So, undoubtedly this textbook fulfils the needs of practitioners. My
hearty congratulations to the authors for taking this great initiative.
Department of Ophthalmology Naoyuki Maeda
Osaka University Graduate School of Medicine,
Suita City, Osaka, Japan
vii
Preface
Keratoconus is an eye problem that affects young individuals. It is associated
with significantly impaired vision-related quality of life (VRQoL). Many
times, patients with keratoconus have associated allergy, which additionally
impacts their daily activities. While early cases can be managed by glasses,
there are various options for moderate to advanced disease. Whenever I
examine these patients, especially children, I feel the challenges are many
despite newer diagnostic techniques and treatment modalities.
Coming across the increasing number of patients with keratoconus in my
clinical practice drove me to editing a comprehensive book on keratoconus to
help cornea specialists and general ophthalmologists to better manage kera-
toconus cases. The authors are experts in their field and from various parts of
the world.
Technology is emerging fast for the diagnosis of keratoconus. Similarly,
the armamentarium of its visual rehabilitation procedures has expanded.
Collagen crosslinking is a boon for these patients. Research is underway to
understand the pathogenesis of the disease and its progression. I hope this
book will be a useful guide and a ready reference for ophthalmologists in
managing cases of keratoconus.
Bhubaneswar, Odisha, India Sujata Das
ix
Contents
1 Epidemiology of Keratoconus . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Smruti Rekha Priyadarshini and Sujata Das
2 Etiology and Risk Factors of Keratoconus . . . . . . . . . . . . . . . . . . 11
Mark Daniell and Srujana Sahebjada
3 Biomechanics of Keratoconus . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Kanwal Singh Matharu, Jiaonan Ma, Yan Wang,
and Vishal Jhanji
4 Pathophysiology and Histopathology of Keratoconus . . . . . . . . . 31
Somasheila I. Murthy, Dilip K. Mishra, and Varsha M. Rathi
5 Clinical Diagnosis of Keratoconus . . . . . . . . . . . . . . . . . . . . . . . . . 45
Zeba A. Syed, Beeran B. Meghpara,
and Christopher J. Rapuano
6 Classifications and Patterns of Keratoconus . . . . . . . . . . . . . . . . 59
M. Vanathi and Navneet Sidhu
7 Differential Diagnosis of Keratoconus . . . . . . . . . . . . . . . . . . . . . 69
Elias Flockerzi, Loay Daas, Haris Sideroudi,
and Berthold Seitz
8 Keratoconus in Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Vineet Joshi and Simmy Chaudhary
9 Allergic Eye Disease and Keratoconus . . . . . . . . . . . . . . . . . . . . . 105
Prafulla Kumar Maharana, Sohini Mandal,
and Namrata Sharma
10 Topography and Tomography of Keratoconus . . . . . . . . . . . . . . . 117
Shizuka Koh
11 Newer Diagnostic Technology for Diagnosis of Keratoconus . . . 129
Rohit Shetty, Sneha Gupta, Reshma Ranade,
and Pooja Khamar
12 Acute Corneal Hydrops: Etiology, Risk Factors,
and Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Tanvi Mudgil, Ritu Nagpal, Sahil Goel, and Sayan Basu
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xii Contents
13 Contact Lenses for Keratoconus . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Varsha M. Rathi, Somasheila I. Murthy, Vishwa Sanghavi,
Subhajit Chatterjee, and Rubykala Praskasam
14 Corneal Cross-Linking in Keratoconus . . . . . . . . . . . . . . . . . . . . 183
Farhad Hafezi and Mark Hillen
15 Penetrating Keratoplasty in Keratoconus . . . . . . . . . . . . . . . . . . 193
Ankit Anil Harwani and Prema Padmanabhan
16 Lamellar Keratoplasty in Keratoconus . . . . . . . . . . . . . . . . . . . . . 205
Jagadesh C. Reddy, Zarin Modiwala, and Maggie Mathew
17 Intracorneal Ring Segments in Keratoconus . . . . . . . . . . . . . . . . 221
Andreas Katsimpris and George Kymionis
18 Intraocular Lens (IOL) Implantation in Kertaoconus . . . . . . . . 231
Seyed Javad Hashemian
19 Stromal Augmentation Techniques for Keratoconus . . . . . . . . . . 251
Sunita Chaurasia
20 Cataract Surgery in Keratoconus . . . . . . . . . . . . . . . . . . . . . . . . . 257
Wassef Chanbour and Elias Jarade
21 Refractive Surgery in Management of Keratoconus . . . . . . . . . . 267
Jorge L. Alió, Ali Nowrouzi, and Jorge L. Alió del Barrio
22 Artificial Intelligence in the Diagnosis and Management
of Keratoconus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275
Nicole Hallett, Chris Hodge, Jing Jing You, Yu Guang Wang,
and Gerard Sutton
23 Changing Paradigm in the Diagnosis and Management
of Keratoconus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291
Rashmi Sharad Deshmukh and Pravin K. Vaddavalli
About the Editor
Sujata Das, MS, FRCS, AMPH, D.Sc.(h.c.) is a

faculty member at the L V Prasad Eye Institute
(LVPEI), Bhubaneswar, India. She received her
postgraduate training in ophthalmology from
MKCG Medical College and Hospital, Odisha,
India, and FRCS (Glasgow) in ophthalmology.
She completed her subspecialty training in cornea
and anterior segment from LVPEI, Hyderabad,
India. Further, she completed her ICO fellowship
in cornea at the University of Erlangen-
Nuremberg, Germany, and clinical fellowship in
cornea at the Royal Victorian Eye and Ear Hospital
and CERA, Melbourne University, Australia. She
has pursued an advanced management program
for health care from the Indian School of Business,
Hyderabad, India, and received a DSc. (honoris
causa) from the Ravenshaw University, Odisha,
India. She is a recipient of several national and
international awards.
Dr Das is presently involved in research
encompassing corneal infections, eye banking,
keratoconus, and genetic analysis of Fuchs’ endo-
thelial corneal dystrophy. She has authored over
140 peer-reviewed papers and book chapters to
her credit. She has published a book entitled
Infections of the Cornea and Conjunctiva.
xiii