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CLEK collaborative longitudinal evaluation of keratoconus

METHODS: The CLEK Study is an 8-year, multi-center, natural history study of 1209 patients with keratoconus who were examined annually for 8 years. Its goals are to prospectively characterize changes in vision, corneal curvature, corneal status, and vision-specific quality of life.

RESULTS: CLEK Study subjects had a mean age at baseline of 39.3+/-10.9 years. At study entry, 65% of the patients wore rigid contact lenses, and 14% reported a family history of the disease. Subjects exhibited a 7-year decrease in high- (2.03 letters) and low- (4.06 letters) contrast, best-corrected visual acuity, with 19% demonstrating decreases of 10 or more letters in high-contrast, best-corrected acuity and 31% of subjects demonstrating decreases of 10 or more letters in low-contrast, best-corrected acuity in at least one eye. Subjects exhibited an average 8-year increase in corneal curvature of 1.60D in the flat corneal meridian, with 24% demonstrating increases of 3.00D or more. The 8-year incidence of corneal scarring was 20%, with younger age, corneal staining, steeper baseline corneal curvature, contact lens wear, and poorer low-contrast visual acuity predictive of corneal scarring. Data from the National Eye Institute Visual Function Questionnaire suggest that the effect of keratoconus on vision-specific quality of life is disproportionate to its low prevalence and clinical severity.

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Toric lens for keratoconus

A 55-year-old man with forme fruste keratoconus with a preoperative uncorrected distance visual acuity (UDVA) of 20/800 and a refraction of -6.50-3.00×135 and a 46-year-old man with a claw-shaped topographic pattern, a family history of keratoconus, and a UDVA of 20/800 with a refraction of -5.00-3.00×85. The refraction had been stable for at least 5 years in both patients. Phacoemulsification and implantation of an acrylic toric IOL were uneventful. One year postoperatively, the UDVA was 20/25 in both cases, with a refraction of -0.25-0.50×140 and 0.25-0.50×60, respectively. No progression and no IOL rotation were observed. Toric IOLs may provide excellent outcomes in patients with stable and nonprogressive corneal ectasia

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Hormone and keratoconus

This study is from Clek or the collaborative longitudinal evaluation of keratoconus. It came from college of optometry in Ohio.
METHODS: The severity and progression of keratoconus in both men (M) and women were evaluated over a 4-year period that encompassed menopausal transition for hormone-active women (HA) and hormone-inactive women (HI). Four outcome measures were selected as indicators of the severity of keratoconus: high-contrast best-corrected visual acuity, low-contrast best-corrected visual acuity, the steep keratometric measurement, and corneal scarring (yes/no).

RESULTS: There were no statistically significant differences among the 3 groups (M, HA, and HI) in race, history of atopic disease, family history of keratoconus, or rigid contact lens wear in the right and left eyes. At baseline, there were no significant differences among the 3 groups in high-contrast best-corrected visual acuity, low-contrast best-corrected visual acuity, or steep keratometric reading. Progression of keratoconus, as assessed by changes in these 3 continuous variables, was equal for the 3 groups. M had more corneal scarring than did HA or HI; however, there was no progression of scarring for any of the groups.

CONCLUSION: Keratoconus progressed in both men and women, aged 48-59 years; however, there were no differences among the groups in progression.
So what we learn her is that if you live in Los Angeles and suffer from keratoconus, there is still a chance of scarring even if you are in your fourties. You need to see Los Angeles cornea expert . Dr Khanna has offices in Beverly hills and west lake village and helps residents of Los Angeles with management of keratoconus.

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Genetics of keratoconus

Keratoconus (KC) is a bilateral, non-inflammatory, and progredient corneal ectasia that mostly occurs as a sporadic disorder, but it has long been recognized that a significant minority of patients also exhibit a family history. In Los Angeles in recent years several candidate genes such as VSX1 and SOD1 have been proposed, and some disease-causing mutations have been identified. Keratoconus research in united states has also focused on collagen genes, especially those that are differentially expressed in KC cornea. Alterations in COL4A3 and COL4A4 genes may be responsible for decreases in collagen types I and III, a feature often detected in Los angeles keratoconus.

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How intac works

Intacs is a method of treating keratoconus typical just to understand how it works we need to follow and Seabrook us get the corners in the house it’s a disease affects the I imagine a person with the big daddy and another with a flat abdomen the person to person has the belly button pointing fall it’s that is the new way to OBs person has the Betty button pointing downloads to bring the baby bed and back hop on a break maybe place under the bed he same thing happens in kettle corn is corn meal because if he does and weakness start sagging in pointing down much for being the apex of the Carne I’m back up towards plastic segment called and asked me to place due to Cici if he is going along the road and see somebody standing on the side we have to be careful to decide whether to give him a ride in the Kado know. In Los angeles keratoconus can be treated with intacs

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Keratoconus in Singapore

<ins datetime="2010-12-22T14:45:58+00:Mean age of our patients was 29.5 ± 9.40 years on enrolment, 62.9% males, and the ethnic distribution was 60.3% Chinese, 13.8% Malays, and 9.5% Indians. Clinically-evident keratoconus was present in both eyes of 65 patients (56.0%) and unilateral keratoconus in 5 patients (4.3%). Five patients (4.3%) had a family history of keratoconus. The majority of patients were managed with contact lenses (60.8%) or glasses (24.5%). Eye-rubbing was common (68%) as were atopic conditions such as asthma (26.3%) and eczema (18.4%). Conical protrusion was the commonest sign (75.3%). The mean cylinder was higher in keratoconus eyes compared to keratoconus suspect eyes (-4.01 vs -1.27, p < 0.001) while best corrected VA was significantly poorer (0.19 vs 0.05, p < 0.001). Unaided VA was significantly worse with increasing age (p = 0.016)Baby interesting study from Singapore body chill and Dan has shown that candidate Glenys incidents and the EVA indication population is similar to dad falling in the distant countries like United States Navy studied the allegations of chemical message came to the hospital and found the average age was 30 years and did the range from 20 to 40 years in Singapore this phone does all the population 60% with Chinese & order for Indian origin photo at 5% off then had relatives quit being diagnosed with Canada calling us and butter under treatment most of the patients were meals and or lease sign in the station is depicted in photography laws go any further on vision of function questionnaire because found that activities of the living for affected more than what could have been simply the case for the kind of fish and they had so you give me a mix of common conclusion that keratoconus going to spend presence in early in the eastern hemisphere like a vested hemisphere me of the more commonly affected and it’s a disease that you fix both eyes read it just have I may have a small chance of suffering from the same disease keratoconus

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Turkey

I have been diagnosed iwth kerataconus in my right eye.

in 2 years it is changed from 45D to 47D. Doctors recommend crosslinking.

Could you please inform me about the prices of CCL. I ahev no problem with left eye. Is it suitable to continue with glasses after CCL; instead of contact lens.

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India with Love

Hi this is Sh…. from Bangalore, India. I am Suffering from keratoconus since 2000. There has been a progression from left eye and now to right eye.. currently using piggyback lens for left eye.. cannot wear for more than 4-5 hours continuously..Suggest better methods

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Keratoconus Foundation

Hi ,

My name is D, I am Tanzanian student , studying in US.

I was reffered to you by National keratoconus foundation in California. I contacted them because I have a brother (23 years old) In Tanzania, East Africa who was diagnosed with Keratoconus last year. He has not been able to get treatment in my country and he is loosing his vision.

I was looking for ways for him to come here in US to receive Corneal transplant.

The problem is my family can not afford medical expenses and I am looking for Medical financial Assistance for him.

I am emailing you to ask you for the following informations:

1)Do you help people outside to come to US for treatments?

2) If Yes, which procedures should I follow?

3)If No, Do you have any information on organisations or hospitals around US t hat help keratoconus patients financially to get treatment(- Who can not afford medical expenses)

I have been searching for help, his sight is getting worse and It is sad that he is young and has no help around.

I am thanking you for reading this and looking forward to hear from you. My cell number is

Sincerely,

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PRELEX Explained


Your cornea (the outside part of the eye) and the eye’s natural lens (inside your eye) work together to focus light that comes into your eye on to the retina which is like a photographic film of a traditional camera. The lens, which is flexible when you are younger, becomes increasingly inflexible as you mature, often after you’ve passed the age of forty. Consequently, you have a difficult time focusing on objects. This condition is known as presbyopia.

The onset of presbyopia has traditionally meant that you are relegated to using reading glasses or cheaters for clear vision. And here’s a secret, even those individuals who’ve received laser vision correction will eventually become presbyopic and need glasses or contacts to restore their full range of sight.

Beverly Hills PRELEX offers a solution. Unlike procedures that focus on changing the shape of the cornea, PRELEX works on the dysfunctional lens inside the eye. Consequently, your vision after the procedure will be stable and unlikely to change over time. In addition, cataract surgery will not be necessary later in life. The presbyopic lens that is used to replace your eye’s natural lens will provide you with clearer vision at all distances, giving you little or no dependence on traditional or progressive bifocal glasses.

How is the PRELEX procedure performed?

Dr.Khanna  removes the eye’s dysfunctional lens using pressure waves and replaces it with a small plastic presbyopic lens. It is then unfolded and placed into permanent position. Patients go home soon after the procedure to relax for the rest of the day. Many patients report improvement in their vision almost immediately Some patients have gone to work the same day. Everyone heals somewhat differently, and most return to their normal activities within a day or two. PRELEX is usually performed on the second eye a week to two after the first procedure.

PRELEX vs. LASIK?

Although Los Angeles LASIK surgery may reduce the need for glasses or contacts, it cannot correct presbyopia and restore the eye’s full range of motion. An additional advantage to PRELEX surgery is that once you have had the procedure, you will not require cataract surgery later in life.

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