Stabilizing Corneal Diseases (Keratoconus) Through a Keraring Implant

Keratoconus is a genetically inherited disease that affects the normal shape of the cornea, causing it to lose its stability and bow forward irregularly, which results in a reduction and distortion of vision.

Keraring implant with the femtosecond laser

A Keraring implant with the femtosecond laser can stall this progressive protuberance of the cornea. Generally, the implants stabilize the cornea and thereby also stabilize the vision. An improved adaptation of glasses or contact lenses is thus possible. You can see how exactly the surgery works in the video Are you suffering from keratoconus and are you considering a long-term solution? We will provide you with an overview of the clinical picture and the suitable treatment method.

What is Keratoconus?

The word Keratoconus derives from two Greek words: “kerato”, which means cornea, and “conus”, which means cone. Keratoconus is a genetically inherited disease that effects the normal form of the corneal shape, causing it obtain a cone-like shape–the reason for the reduced vision. The Keraring is mostly implemented when the disease has reached its advanced stages and contact lenses have become intolerable, or the corneal shape too irregular. The Keraring can stall this progressive curving of the cornea, and thereby indefinitely postpone the need for a corneal transplant.

Treating Keratoconus:

  • Glasses: in the early stages
  • Hard contact lenses: when glasses are no longer sufficient
  • Implantation of corneal rings: when contact lenses have become intolerable, or the protuberance is increasing
  • Corneal transplant: In the final stages (carried out in the laser eye clinic in Munich): A LASIK surgery to improve the vision is not possible in this case.
 

The Keraring Procedure – Step by Step

First, a tunnel is prepared for the ring to be inserted into. EuroEyes uses the femtosecond laser for this–just like in the Femto LASIK treatment–which makes the most precise incisions within 6 seconds. The ring is then inserted carefully into this tunnel, and carefully positioned. The rings “tighten” the corneal cone and thereby create a more regular corneal surface.

Keraring Treatment Procedure

1.  Personal, Non-binding Consultation

  • All relevant eye parameters are measured
  • Examine your eyes to make sure you are a suitable candidate for the Keraring treatment

2.  A Thorough Medical Preliminary Examination

  • The examination usually lasts about two hours
  • Intensive ophthalmic preliminary examination and measurement of your eyes
  • Our Specialists in ophthalmology will explain every detail about the treatment
  • Before this preliminary examination you should not have worn soft contact lenses for one week and hard contact lenses for two weeks
  • Please note that after the examination you will not be safe driving a vehicle–neither car, nor motorcycle or bicycle. We therefore recommend that you take a cab or public transportation
  • At the examination you will receive an after-care set for the days after your treatment. The medication and content will be explained in detail by our staff

3.  On the Day of Your Keraring Treatment

  • We recommend that you wear comfortable clothes on the day of treatment
  • You can eat and drink normally on the treatment day, but please do not smoke
  • For hygiene reasons, it is also important that you wash your face thoroughly prior to treatment, completely remove makeup, and avoid perfume
  • Anesthetic eye drops
  • Outpatient surgery, no bandage, and sunglasses are recommended
  • The total duration of the surgery (one eye): approximately 10-15 minutes
  • You are not allowed to drive a vehicle after the procedure

4.  After the Keraring Surgery

  • The eye can be a little red–please do not rub your eyes
  • How and when to use the antibiotic eye drops, the combination product that has a preventive effect against swelling and inflammation, and the pain-relieving eye drops will be discussed with your doctor beforehand
  • Return to work after 2 days
  • Resume sports activities after approximately 3 days, swimming and sauna after approximately 2 weeks
  • Post-operative follow-up examinations: after 1 day – 1 week – 1 month
  • You may drive a vehicle again only with the doctor’s permission, normally after the 1 week post-operative examination
 

Good to Know about Kerarings

This is the Most Modern and Safe Treatment Method of Keratoconus

The keraring is made out of artificial material, Perspex CQ Acrylic, which is the same material used for more than 20 years for cataract treatments, and is therefore tolerated so well by the cornea that no risk of reje
  • The eye quickly recovers from the surgery, and the vision therefore improves within a couple of days, and stabilizes within 3 to 6 months. During this time, vision fluctuations can occur. It may be necessary to wear glasses or contacts after the surgery–even though the vision, despite a small remaining refractive error–will be pretty good.
  • The success of the surgery depends on the severity of the corneal disease. The earlier this treatment is carried out, the greater the success rate. If carried out in time, as much as 95% of all progressive cases can be stopped.
  • The risk of complication is very low, however, as by any other surgery, an infection may occur. Complications are generally not severe, and in case they do occur, this treatment is reversible and the rings can be removed, allowing the cornea to return to its original shape.

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Frequently Asked Questions about Kerarings

A keraring is an artificial ring, which consists of two semicircular segments at 5 mm in diameter and of variable thickness. The ring is made out of artificial material, Perspex CQ Acrylic, which is the same material used for more than 20 years for artificial lens implants in cataract and refractive lens exchange surgeries. The keraring is tolerated so well by the cornea that no risk of rejection exists. The main reason for the surgery is the improvement of visual acuity. Kerarings can stall the progression of keratoconus and thus delay the cornea transplant indefinitely. Once the Keraring is in place a crosslinking is performed to stabilize the cornea.
1. Moderate to high nearsightedness
2. Severe astigmatism
3. Irregular astigmatism from Keratoconus or after a corneal transplant.

How does the surgery happen?



First, the visual axis is marked on the cornea, then a tunnel is prepared using the femtosecond laser. The femtosecond laser places the incisions very precisely in 6 seconds. The rings are inserted into the tunnel, and subsequently, a bandage contact lens is applied.
The risk of complication is very low. However, as with any other surgery, an infection may occur. Complications are generally not severe, but if they do occur, the kerarings must be removed. This is also necessary if the rings extrudes out of the tunnel. Despite a surgery, a corneal transplant may become necessary. The keraring is no replacement of the corneal transplant.