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Academician Dr. Artsybashev operează din 1986, pe toate stagiile de keratoconus (I-IV) fără nici o complicaţie
Academician Dr. Artsybashev operează din 1986, pe toate stagiile de keratoconus (I-IV) fără nici o complicaţie

Surgical Treatment of Keratoconus

Keratoconus (lat. Keratokonus) is a disease of the cornea in which it becomes very convex and thin, leading to numerous refractive abnormalities. It is estimated that 20% of patients will progress to the point where a corneal transplant is deemed necessary. Artsybashev Clinic strives to provide an alternative for those patients.

The diamond ophthalmic surgery technique developed by Academician Dr. Artsybashev has shown stable results after surgery for over 15 years. The shape of the cornea is altered through a series of small incisions on the periphery of the cornea. The aim of the procedure is to reverse the effects of keratoconus. Ongoing research is showing a continual reduction in the “cone” during the recovery period leading to improved visual acuity.

It is important to note that while this method is based on the principles of radial keratotomy, there are a number of key differences. In radial keratotomy, a micrometer knife is set to a certain depth for a simple incision. The corneal thickness in a keratoconic cornea may vary by as much as 100 or 200 microns within a single millimeter. Using a special technique, Dr. Artsybashev is constantly changing the depth of each incision to avoid perforations. Even a microperforation can have serious consequences for a patient. The loss of elasticity also complicates the operation. Years of training and 1000’s of successful practice operations are required before a surgeon may even attempt an early stage keratoconus case. With over 30,000 completed surgeries, Dr. Artsybashev is comfortable operating on the most difficult cases.

The operation is performed under local anesthesia and requires an average of 2-3 minutes per eye. Even the most difficult cases are completed in under 5 minutes. The result of the operation is felt on the next day. Patients are discharged from the hospital with a medical certificate the day after the operation. Patients’ medical supervision and monitoring is conducted one month, three months, six months, one year, and two years after the operation. Postoperative treatment has been developed to provide the best scarring of the microcuts. This process provides a framework for strengthening the cornea. Since 1986 Dr. Artsybashev has performed over 1000 operations on all stages of keratoconus (I-IV). Diamond ophthalmic surgery has been performed after CXL, Intacs/Ferrara, tPRK, Lasik, and even PKP (Corneal Transplant). Every operation requires customized calculations due to the varying shape of each cornea. Therefore, a thorough examination is required prior to all operations.

 

Diamond Ophthalmic Surgery Performed After PKP

25 years after a corneal transplant for keratoconus, a woman noticed her vision deteriorating. Another ophthalmologist determined that the keratoconus was reactivating. Due to a decreased number of endothelial cells (the single layer of cells that separates the cornea from the aqueous humor), the ophthalmologist concluded that retransplantation was too risky. During the pre-op consultation she could only count fingers within 10cm from the eye. The patient also has a longer than normal axial length of the eye causing myopia (nearsightedness).

A series of two surgeries were performed by Dr.Artsybashev to decrease the astigmatism and myopia. The topography below shows the pre-op state in September 2010 on the left. The picture on the right is from the 1 year control. Her uncorrected vision at that time was 30% or approximately 20/60.

Diamond Ophthalmic Surgery Performed After PKP

1 Year Control

Pre-op UCVA: <10cm         Post-op UCVA: 0.3 (20/60)

 

Stable Results 15 Years After Surgery for Stage II Keratoconus w/ Compound Myopia

Stable Results 15 Years After Surgery for Stage II Keratoconus w/ Compound Myopia

Impressive results 15 years after treatment of Keratoconus Stage II by Dr. Artsybashev

Impressive results 15 years after treatment of Keratoconus Stage II by Dr. Artsybashev

 

 

Keratoconus Stage II Results

Keratoconus Stage II Results

Keratoconus Stage II Results

 

OD

OS

 

Pre-op UCVA:

20/200

20/60

 

Post-op UCVA:

20/40

20/22.5

 

 

4-Month Control Visit:

Keratoconus Stage II - 4-Month Control Visit

Uncorrected visual acuity at 4 month control:

 

OD

OS

 

4 Month Post-op:

0.7-0.8

0.9-1.0

 

 

 

Treatment of Stage II Keratoconus 1 Year Results

Treatment of Stage II Keratoconus 1 Year Results

Uncorrected visual acuity:

 

OD

OS

 

Pre-op UCVA:

0.6

0.4

 

1 Year Post-op UCVA:

0.8

1.0

 

 

 

Keratoconus Stage II/III Immediate Results

Keratoconus Stage II/III Immediate Results

Uncorrected visual acuity improved from 0.05 (20/400) to 0.6 (20/35) when measured one day following surgery.

 

Keratoconus Stage II/III - 6 month control

Uncorrected visual acuity at 6 month control is 0.9.

 

 

Keratoconus Stage III/IV Results

Keratoconus Stage III/IV Results

Keratoconus Stage III/IV Results

Keratoconus 6 Month Results

 

OD

OS

 

Pre-op:

0.25

0.05

 

1 Month Post-op:  

0.55

0.55

 

3 Month Post-op:

0.95

0.95

 

6 Month Post-op:

1.0

1.0

 

 

 

Advanced Stage IV Keratoconus w/ Central Leucoma

 

Pre-Operative Examination UCVA without correction (Day 1):

Visual Acuity:     

OD = 0.2 - 0.3

OS: 0.16-0.2

 

Ophthalmometer:

OD:  v = 60.0

OS:  v = ↑ 80.0

 

 

h = 53.0

h = ↑ 75.0

 

 

Post-Operative Examination UCVA without correction (Day 3):

Visual Acuity:

OD:  0.5-0.6

OS: 0.3-0.4

 

Ophthalmometer: 

OD:   v = 44.0

OS:  v = 60.0

 

 

h = 46.0

h = 55.0

 

 

6 Month Results

Right Eye (OD)

Pre-op: October 29, 2009

UCVA:  0.2-0.3

6 Month Post-op:  June 14, 2010

UCVA: 0.9

Keratoconus Keratoconus 6 Month Results

Left Eye (OS)

Pre-op: October 29, 2009

UCVA:  0.16-0.2

6 Month Post-op:  June 14, 2010

UCVA: 0.5

Keratoconus Keratoconus 6 Month Results

 

1 Year Control Visit:

Keratoconus IV - 1 Year Control Visit

 

Further results will be added as they become available.

Articole

The Russian Hungarian Connection: Doctor Artsybashev Vs Keratoconus (The Global Kertoconus Foundation, 04.2010)

 

"Salvarea corneei" vine dinspre Budapesta (Evenimentul Zilei, 12.04.2010)

 

Interviu pacient

© Clinica Oftalmologică Artsybashev, 2008-2010

Clinica Oftalmologică Artsybashev

Addresa: 19. Számadó utca, Budapest, 1118.

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