Keratoconus – Case Study

Keratoconus is the progressive degeneration and weakening of the structure of the cornea – the clear tissue that covers the front of the eye. Keratoconus symptoms affect everyday tasks like driving, watching television and reading. Patients with severe Keratoconus may barely achieve 20/200 vision even with glasses or contacts. In the past, this patient would likely require a corneal transplant to restore vision. This is a lengthy surgery with a moderate success rate, yearlong healing course and a potentially uncomfortable hard contact lens requirement.

Steve Wozniak -- Apple co-founder

Steve Wozniak
Apple co-founder


Patient Information and Diagnosis

  • Steve Wozniak had LASIK in 2000 when he was 49 years old.
  • After LASIK, he enjoyed 20/20 distance vision for about 8 years
  • In 2008, the vision in his right eye was found to be about 20/50. He was diagnosed with Ectasia, a rare form of Keratoconus.
  • By 2013, his right eye had deteriorated to 20/400 and his Ectasia had worsened. His vision could now only be corrected to 20/60 with glasses.
  • Stability of vision for 3 years

Keratoconus Treatment Recommendation and Procedure

Instead of a corneal transplant, I recommended three simultaneous procedures:

  • Corneal Cross Linking saturates the cornea with Vitamin B2 and exposes it to ultraviolet light. This causes the collagen to cross-link with adjacent collagen molecules, strengthening the cornea and preventing further deterioration.
  • Intacs, an FDA-approved plastic segment, are inserted into the cornea. This segment flattens the cornea thereby reducing nearsightedness.
  • Conductive Keratoplasty reshapes the cornea to reduce the astigmatism.

Results

Steve was treated in April 2013. Two weeks after the procedure, his vision had improved from 20/400 (uncorrected) and 20/60 (uncorrected), to 20/30 (with glasses)!


Steve talks about his experience

Dr. Furlong and Steve Wozniak

Why did you choose this treatment?
I chose this because I got a good recommendation and explanation from Dr. Furlong —  a doctor I trust. He also explained why it was a good idea and why my vision might get worse if I didn’t have the surgery.

How would you describe the overall experience?
Easy. It was very similar to having had LASIK. I had full confidence in the doctor and I was fully conscious during the procedure. Enjoyable. My wife enjoyed watching.

How would you describe your results?
Excellent. The recovery was longer than with LASIK, but I was prepared for that. It actually exceeded my expectations. I still would have been happy if my results were less than what they are.

With the advent of the recent FDA approval of a single treatment system and protocol, Dr. Furlong is not offering Corneal Cross Linking (CXL) at this time. He is researching several alternative treatment protocols that are being evaluated for patient comfort, recovery time and efficacy. Dr. Furlong will continue to examine and diagnose Keratoconus patients and offer Conductive Keratoplasty (CK) and Intacs treatments for those patients who will benefit from these procedures and will resume CXL treatment once he determines which protocol offers the best outcome and safety.

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