Corneal Physiology and Responses to Cross-Linking and Intracorneal Rings in Keratoconus

Keratoconus is a noninflammatory, usually, bilateral progressive disease. It is a pathology characterized by a progressive thinning and ectasia of the stroma that results in cone-shaped cornea. In advanced keratoconus with corneal opacities, keratoplasty, can be the only surgical alternative for a long time. Recently, new treatment alternatives were developed in keratoconus treatment, such as intracorneal ring segments and corneal crosslinking. Intracorneal ring segment acts as spacer elements between the bundles of corneal lamellae producing a shortening of the central arc length. Corneal cross-linking treatment increases the stiffness of the cornea. Several studies reported that collagen cross-linking can delay or stop keratoconus progression and produce better quality of vision.