Risks and Complications of Corneal Tissue Addition: What Patients Should Know

The Most Advanced Keratoconus Treatment: CTAK

Keratoconus is a progressive eye condition that causes the cornea, the clear front part of the eye, to thin and bulge into a cone-like shape. This irregular shape can lead to significant vision problems, including blurred and distorted vision, light sensitivity, and difficulty driving at night. Traditional keratoconus treatments include eyeglasses, contact lenses, corneal cross-linking, and in advanced cases corneal transplants. Happily, a newer and more advanced treatment option has emerged: Corneal Tissue Addition Keratoplasty (CTAK).

CTAK is a surgical procedure that involves adding preserved, sterilized corneal tissue to the eye to help restore the cornea’s natural shape and improve visual acuity. This innovative treatment has shown promising results in treating advanced cases of keratoconus, where other treatments may no longer be effective. By understanding the risks and complications associated with CTAK, you can make an informed decision about whether this procedure is the right choice for your unique eye health needs.

What is Corneal Tissue Addition Keratoplasty (CTAK)?

CTAK is a surgical procedure that aims to treat advanced cases of keratoconus by adding a custom cut corneal tissue inlay to the eye. It is highly effective at flattening the cone shape of the cornea that presents with keratoconus and improving visual acuity. 

CTAK is considered a less invasive, more advanced and highly targeted treatment option compared to traditional corneal transplant procedures. It allows for a more precise and customized approach to addressing the specific shape and curvature issues associated with keratoconus. By adding tissue to the cornea, rather than replacing the entire cornea, CTAK can often achieve better visual outcomes and reduce the risk of certain complications that may arise with a full corneal transplant.

Risks and Complications of CTAK

As with any surgical procedure, CTAK carries a certain degree of risk and potential complications. It is essential for patients to be aware of these risks and to discuss them thoroughly with their ophthalmologist before deciding to undergo the procedure. Some of the risks and complications associated with CTAK include:

  1. Infection/Inflammation: There is a risk of infection at the surgical site, which can potentially lead to more serious complications if not properly treated. To mitigate this risk, patients are given antibiotics post-operatively.
  2. Scarring: Scarring can occur at the surgical site, which may impact the cornea’s transparency and affect visual acuity. Patients receive a corticosteroid drop after the procedure is complete to reduce the risk of inflammation and scarring.
  3. Decreased Vision: In very rare cases, the CTAK procedure may not result in the expected improvement in visual acuity, and vision may actually worsen. If this happens, the procedure can be reversed simply by removing the inlay. 

These risks and complications are rare, but should be taken into consideration if you are considering CTAK as part of your overall keratoconus management plan

Preparing for CTAK Surgery

If you and your ophthalmologist have determined that CTAK is the best treatment option for your keratoconus, there are several steps you can take to prepare for the surgery and ensure a successful outcome:

  1. Comprehensive Eye Examination: Always start with a thorough eye examination by one of CLEI’s experienced eye care specialists. This will include measurements of your corneal thickness, curvature, and other key characteristics. This information will help the surgeon plan the CTAK procedure and determine the appropriate size and placement of the corneal tissue inlay.
  2. Discuss Risks and Expectations: Engage in an open and honest discussion with your ophthalmologist about the potential risks and complications associated with CTAK, as well as your expectations for the procedure and the anticipated visual outcomes. Your doctor can help you understand the risks and benefits taking into account your specific case.
  3. Manage Existing Conditions: If you have any other underlying eye conditions or general health issues, work closely with your healthcare team to ensure these are well-managed before the CTAK surgery.
  4. Quit Smoking: Smoking can negatively impact wound healing and increase the risk of complications following CTAK. It is recommended that you quit smoking several weeks or months before the procedure.
  5. Follow Pre-operative Instructions: Your ophthalmologist will provide you with specific instructions to follow in the days and weeks leading up to your CTAK surgery, such as using eye drops or avoiding certain activities. It is crucial that you follow these instructions carefully to optimize the chances of a successful outcome.

By taking these preparatory steps, you can help ensure that your CTAK procedure goes as smoothly as possible and increase the likelihood of achieving your desired visual outcomes.

Choosing the Right Surgeon for CTAK

When it comes to CTAK surgery, the experience and expertise of your ophthalmologist can make a significant difference in the success of the procedure and your overall visual outcomes. CTAK is on the cutting edge of keratoconus treatment, and not all ophthalmologists are familiar with it, or have ever performed it. 

CLEI’s team of surgeons developed the procedure and performed clinical trials, which means we have extensive experience performing the procedure and achieving optimal outcomes. Even if you don’t live close to the CLEI Center for Keratoconus, we encourage you to schedule a consultation with us. We are set up to cater to out of town patients seeking the best possible care, with hotels and transportation conveniently located nearby our facilities. 

Alternatives to CTAK for Keratoconus Treatment

While CTAK is one of the most advanced and effective treatments for keratoconus, it is not the only option available. In addition, not everyone is a suitable candidate for CTAK. Depending on the severity of your condition and your individual circumstances, your ophthalmologist may recommend one or more of the following alternative treatments:

  1. Eyeglasses and Contact Lenses: In the early stages of keratoconus, vision can often be corrected with specialized eyeglasses or specialty contact lenses, which can help to offset the irregular corneal shape.
  2. Corneal Cross-Linking: This procedure strengthens the cornea by using UV light and a photosensitizing eye drop to create new collagen bonds, helping to halt the progression of keratoconus.
  3. Keratoconus Surgery: Other surgical procedures that your doctor may consider to improve your corneal topography include topography-guided PRK, intracorneal rings (Intacs), or a corneal transplant

It is important to discuss all of these treatment options with your ophthalmologist to determine the best course of action for your individual needs and preferences. Each approach has its own set of risks, benefits, and potential outcomes, and your ophthalmologist can help you weigh these factors to make an informed decision.

Conclusion: Making an Informed Decision about Corneal Tissue Addition

CTAK is an innovative treatment option for patients with advanced keratoconus. By understanding the risks and complications associated with this procedure, as well as the factors that can influence its outcomes, you can make an informed decision about whether CTAK is the right choice for you.

Remember, the success of CTAK is heavily dependent on the skill and experience of your ophthalmologist, as well as your own commitment to proper pre-operative preparation and post-operative care. CLEI’s surgeons have the skills and experience to perform CTAK with optimal visual outcomes, but you’ll still need to be an active participant in your own eye health journey.

If you’re considering CTAK or other treatment options for your keratoconus, schedule a consultation with us today to discuss your unique needs and determine the best course of action.

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