Keratoconus Surgery and Cross-linking Roberto Pinelli, Antonio Leccisotti
INDEX
×
Chapter Notes

Save Clear


1Keratoconus Surgery and Cross-linking
2Keratoconus Surgery and Cross-linking
Roberto Pinelli MD Scientific Director Istituto Laser Microchirurgia Oculare Brescia, Italy President of Italian Refractive Surgery Society Antonio Leccisotti MD PhD Visiting Professor School of Biomedical Sciences University of Ulster, Coleraine, UK and Director Department of Ophthalmology Casa di Cura Rugani Siena, Italy Foreword Stephen D Klyce
3Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
Corporate Office
4838/24 Ansari Road, Daryaganj, New Delhi - 110 002, India, +91-11-43574357 (30 lines)
Registered Office
B-3 EMCA House, 23/23B Ansari Road, Daryaganj, New Delhi 110 002, India
Phones: +91-11-23272143, +91-11-23272703, +91-11-23282021,
+91-11-23245672, Rel: +91-11-32558559 Fax: +91-11-23276490, +91-11-23245683
Branches
USA Office
1745, Pheasant Run Drive, Maryland Heights (Missouri), MO 63043, USA, Ph: 001-636-6279734
Keratoconus Surgery and Cross-linking
© 2009, Jaypee Brothers Medical Publishers
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editors and the publisher.
First Edition: 2009
9788184486506
Typeset at JPBMP typesetting unit
Printed at Ajanta Offset
4To
My wife Elena
and
My twins Chiara and Francesco
For their patience during the time spent away from them
— Roberto Pinelli
To
My beloved ones
— Antonio Leccisotti
5Foreword
I discovered many years ago that to truly understand a subject and to be able to distinguish between fact and conjecture, one has to read as many opinions on the subject as are available. What comes out as the distilled product is the knowledge that we all seek.
Dr Roberto Pinelli and Dr Antonio Leccisotti have assembled outstanding experts who have made recent major advances in the management and treatment of keratoconus. This is a disease that apparently affects only the cornea, yet is associated with so many other conditions. It is clear that keratoconus has a genetic basis and that a cure is not possible within current medical knowledge.
Corneal transplants have been very successful in the minority of cases requiring it, as many eyes with keratoconus stabilize at a stage where functional vision can be maintained with spectacles, and possibly with insert or contact lenses, although it is recognized that contact lenses can exacerbate progression or cause scarring. We need to find ways to predict the progression of keratoconus in the individual patient and to treat these before there is significant visual loss. So now there is the hope that keratoconus might be stabilized—even modestly regressed—with collagen cross-linking. Time will tell, but we have gone from guarded optimism to unbridled enthusiasm that collagen cross-linking may prove to be very effective in the management of ectasia, thanks to the pioneering work from Dresden!
Stephen D Klyce phd
Department of Ophthalmology
Mt Sinai School of Medicine
New York, USA
6Contributors
7
8Preface
Many aspects contribute to the fact that keratoconus is an ideal link between refractive and corneal surgery. The expansion of the options for the visual rehabilitation in keratoconus has partly originated from the progress of diagnostic and therapeutical techniques in refractive surgery. Intrastromal rings and phakic IOLs, to mention a few, were conceived to correct myopia but have found a natural and successful application in keratoconic eyes. But some of the new techniques discussed in this book were expressly ideated to strengthen (collagen cross-linking) or to replace (lamellar keratoplasty) a weakened corneal stroma. The subject of the surgery of keratoconus has therefore become so wide that no single surgeon can exhaustively cover all its aspects.
With this in mind, we wanted to gather the experience of some of the most valuable keratoconus surgeons in the world in a comprehensive book. Some of the contributors are old friends who did not let us down in this daunting task, some are new friends who honoured us by believing in our project. Everyone is an outstanding surgeon and, above all, a brilliant medical writer, this latter quality being nowadays much rarer than the former. Thanks to such collaborations, the final result has reached the excellence we had in mind when the book was first planned.
We would like to thank the entire team of Istituto Laser Microchirurgia Oculare, Brescia—Italy and the Assistants of Dr Leccisotti for their blessings and motivation.
Roberto Pinelli
Antonio Leccisotti