An Argentine doctor leads an innovative corneal remodeling technique

Published by: MRT

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Guillermo  Lobo

Keratoconus is an ophthalmological pathology that deforms the cornea. It can appear during adolescence, up to around the age of 20. This disorder has a hereditary factor: one in 10 people has a family member who also suffers from it. It is a silent disease to watch out for because it can lead to progressive loss of vision.

“It consists of the cornea, which is that ‘transparent watch glass’ that we have in the most anterior part of the eye, it is more easily deformed. Then it loses its shape, its physiological profile ”, explains to Con Bienestar María José Cosentino (MN 86,704), former president of the Argentine Society of Cornea, Refractive Surgery and Cataract (SACRyC).

The condition causes blurred and disturbed vision and one or both eyes may be affected. It is more common in people who have asthma or eczema and can also be more common in people who rub their eyes, causing more deformation, as the cornea of ​​the keratoconus patient has less resistance.

“Due to the deformation of the cornea, a irregular astigmatism. It is more difficult to correct, it cannot be compensated with a spectacle, but a contact lens is required, which is generally rigid ”, explains the specialist. When these lenses are not well tolerated, surgery is indicated.

“There is a battery of treatments that we can consider for a patient with keratoconus. If the astigmatism is quite compensable and, in addition, you have myopia, you can opt for the implantation of a phakic lens which is made to measure. When the astigmatism is very irregular and the contact lenses do not give good results, the intracorneal rings that act as a frame, allowing the cornea to stretch and regularize its profile ”, says Cosentino. However, there are small functional areas that do not provide good visual quality.

There are cases where the cornea is “stretched” so much that it generates scars that produce opacities on the cornea. “There is no good vision and none of the options I mentioned works well,” warns the ophthalmologist. In those cases, it is recommended to do a transplant which consists of replacing the cornea with keratoconus with another without keratoconus.

A pioneering technique

“The technique ‘Corneal remodeling’ (corneal remodeling) that we present in one of the most important publications in the world as the Journal of Refractive Surgery, shows long-term results and consists of performing a keratectomy ”, says the co-author of the work together with the specialist César Carriazo, from Colombia.

To perform the keratectomy, a corneal profile of the patient is first removed. Then, in surgery, a very personalized cut is made in the cornea, assisted by a specific laser. The two parts are joined, stretching them as if it were a facelift that is done in cosmetic surgery. By removing the deformation acquired by the keratoconus, the technique allows to recover the physiological state of the membrane.

“There are patients who with this intervention already recover visual quality and quantity enough for your daily tasks. Others complement with glasses or refractive treatments that, if the cornea continues to be altered, could not be indicated ”, concludes María José Cosentino, whose work achieved recognition in the international ophthalmological community and was even published in a book by an English publisher.

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