Management of keratoconus: an updated review
Keratoconus is the most common corneal ectatic disorder. It is characterized by progressive corneal thinning with resultant irregular astigmatism and myopia. Its prevalence has been estimated at 1:375 to 1:2,000 people globally, with a considerably higher rate in the younger populations. Over the pa...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1212314/full |
| _version_ | 1797799787196579840 |
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| author | Rashmi Deshmukh Zun Zheng Ong Radhika Rampat Jorge L. Alió del Barrio Jorge L. Alió del Barrio Ankur Barua Marcus Ang Jodhbir S. Mehta Dalia G. Said Dalia G. Said Harminder S. Dua Harminder S. Dua Renato Ambrósio Renato Ambrósio Renato Ambrósio Darren Shu Jeng Ting Darren Shu Jeng Ting Darren Shu Jeng Ting |
| author_facet | Rashmi Deshmukh Zun Zheng Ong Radhika Rampat Jorge L. Alió del Barrio Jorge L. Alió del Barrio Ankur Barua Marcus Ang Jodhbir S. Mehta Dalia G. Said Dalia G. Said Harminder S. Dua Harminder S. Dua Renato Ambrósio Renato Ambrósio Renato Ambrósio Darren Shu Jeng Ting Darren Shu Jeng Ting Darren Shu Jeng Ting |
| author_sort | Rashmi Deshmukh |
| collection | DOAJ |
| description | Keratoconus is the most common corneal ectatic disorder. It is characterized by progressive corneal thinning with resultant irregular astigmatism and myopia. Its prevalence has been estimated at 1:375 to 1:2,000 people globally, with a considerably higher rate in the younger populations. Over the past two decades, there was a paradigm shift in the management of keratoconus. The treatment has expanded significantly from conservative management (e.g., spectacles and contact lenses wear) and penetrating keratoplasty to many other therapeutic and refractive modalities, including corneal cross-linking (with various protocols/techniques), combined CXL-keratorefractive surgeries, intracorneal ring segments, anterior lamellar keratoplasty, and more recently, Bowman’s layer transplantation, stromal keratophakia, and stromal regeneration. Several recent large genome-wide association studies (GWAS) have identified important genetic mutations relevant to keratoconus, facilitating the development of potential gene therapy targeting keratoconus and halting the disease progression. In addition, attempts have been made to leverage the power of artificial intelligence-assisted algorithms in enabling earlier detection and progression prediction in keratoconus. In this review, we provide a comprehensive overview of the current and emerging treatment of keratoconus and propose a treatment algorithm for systematically guiding the management of this common clinical entity. |
| first_indexed | 2024-03-13T04:24:11Z |
| format | Article |
| id | doaj.art-c397978efb7145cfbf67ab761de9e973 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-13T04:24:11Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-c397978efb7145cfbf67ab761de9e9732023-06-20T08:09:03ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-06-011010.3389/fmed.2023.12123141212314Management of keratoconus: an updated reviewRashmi Deshmukh0Zun Zheng Ong1Radhika Rampat2Jorge L. Alió del Barrio3Jorge L. Alió del Barrio4Ankur Barua5Marcus Ang6Jodhbir S. Mehta7Dalia G. Said8Dalia G. Said9Harminder S. Dua10Harminder S. Dua11Renato Ambrósio12Renato Ambrósio13Renato Ambrósio14Darren Shu Jeng Ting15Darren Shu Jeng Ting16Darren Shu Jeng Ting17Department of Cornea and Refractive Surgery, LV Prasad Eye Institute, Hyderabad, IndiaDepartment of Ophthalmology, Queen’s Medical Centre, Nottingham, United KingdomDepartment of Ophthalmology, Royal Free London NHS Foundation Trust, London, United KingdomCornea, Cataract and Refractive Surgery Unit, Vissum (Miranza Group), Alicante, SpainDivision of Ophthalmology, School of Medicine, Universidad Miguel Hernández, Alicante, SpainBirmingham and Midland Eye Centre, Birmingham, United KingdomSingapore National Eye Centre, Singapore Eye Research Institute, Singapore, SingaporeSingapore National Eye Centre, Singapore Eye Research Institute, Singapore, SingaporeDepartment of Ophthalmology, Queen’s Medical Centre, Nottingham, United KingdomAcademic Ophthalmology, School of Medicine, University of Nottingham, Nottingham, United KingdomDepartment of Ophthalmology, Queen’s Medical Centre, Nottingham, United KingdomAcademic Ophthalmology, School of Medicine, University of Nottingham, Nottingham, United KingdomDepartment of Cornea and Refractive Surgery, Instituto de Olhos Renato Ambrósio, Rio de Janeiro, Brazil0Department of Ophthalmology, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil1Federal University of São Paulo (UNIFESP), São Paulo, BrazilBirmingham and Midland Eye Centre, Birmingham, United KingdomAcademic Ophthalmology, School of Medicine, University of Nottingham, Nottingham, United Kingdom2Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United KingdomKeratoconus is the most common corneal ectatic disorder. It is characterized by progressive corneal thinning with resultant irregular astigmatism and myopia. Its prevalence has been estimated at 1:375 to 1:2,000 people globally, with a considerably higher rate in the younger populations. Over the past two decades, there was a paradigm shift in the management of keratoconus. The treatment has expanded significantly from conservative management (e.g., spectacles and contact lenses wear) and penetrating keratoplasty to many other therapeutic and refractive modalities, including corneal cross-linking (with various protocols/techniques), combined CXL-keratorefractive surgeries, intracorneal ring segments, anterior lamellar keratoplasty, and more recently, Bowman’s layer transplantation, stromal keratophakia, and stromal regeneration. Several recent large genome-wide association studies (GWAS) have identified important genetic mutations relevant to keratoconus, facilitating the development of potential gene therapy targeting keratoconus and halting the disease progression. In addition, attempts have been made to leverage the power of artificial intelligence-assisted algorithms in enabling earlier detection and progression prediction in keratoconus. In this review, we provide a comprehensive overview of the current and emerging treatment of keratoconus and propose a treatment algorithm for systematically guiding the management of this common clinical entity.https://www.frontiersin.org/articles/10.3389/fmed.2023.1212314/fullartificial intelligencerefractive surgerycontact lenscorneacorneal cross-linkingcorneal transplant |
| spellingShingle | Rashmi Deshmukh Zun Zheng Ong Radhika Rampat Jorge L. Alió del Barrio Jorge L. Alió del Barrio Ankur Barua Marcus Ang Jodhbir S. Mehta Dalia G. Said Dalia G. Said Harminder S. Dua Harminder S. Dua Renato Ambrósio Renato Ambrósio Renato Ambrósio Darren Shu Jeng Ting Darren Shu Jeng Ting Darren Shu Jeng Ting Management of keratoconus: an updated review Frontiers in Medicine artificial intelligence refractive surgery contact lens cornea corneal cross-linking corneal transplant |
| title | Management of keratoconus: an updated review |
| title_full | Management of keratoconus: an updated review |
| title_fullStr | Management of keratoconus: an updated review |
| title_full_unstemmed | Management of keratoconus: an updated review |
| title_short | Management of keratoconus: an updated review |
| title_sort | management of keratoconus an updated review |
| topic | artificial intelligence refractive surgery contact lens cornea corneal cross-linking corneal transplant |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1212314/full |
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