Keratoconus

A while back a person called Emu left the following comment and questions:

"Thanks! I've found this a very interesting blog. Are there any known risks relating to C3-R treatment? This may be available elsewhere but I have been unable to find statistics on the success of transplants, and statistics on how successful (% that still need contacts, that only need glasses etc).

I suspect that this is something that other keratoconus patients would be interested in. Perhaps you would consider posting on this at some stage?"

Unfortunately irrespective of whatever treatment is attempted with any disease, there are always risks of something going wrong. Keratoconus is no different.

The first question that Emu asks is about risks with C3-R or Collagen Cross-Linking. This procedure as you might have already read is great at slowing down further progression but:

• There is a small risk of an infection for approximately 4 - 5 days after the procedure as the cornea is healing.
• There is a risk of significant corneal scarring.
• There is a risk of decompensation of the cornea, but this might occur because the procedure was attempted on a cornea that was too thin.
• All these risks are rare but they need to be revealed before a person makes the decision to go ahead.

The second question that Emu asks is what is the success rate of a corneal transplant. This depends in what context it is asked. From a surgeons perspective a corneal transplant is successful if it remains clear and does not reject. From the patients perspective though it is about how well they will see.

Using the Australian Corneal Graft Registry as a reference we can say that 50% of corneal grafts will fail by the 15 year point. The other 50% will slowly fail one by one as the years progress. The oldest corneal graft I have seen was gentleman that was referred for a scleral lens fitting. the graft was 45 years old and is still functioning at the moment with the contact lens - he passes a drivers license test - amazing!

I would say that eventually every patient that has had a corneal transplant will benefit from glasses. How many will require contact lenses is more difficult to answer. Eventually it is not unreasonable to say that up to 50% will require specialized contact lenses to see to a satisfactory level.