Keratoconus Service | Moorfields Eye Hospitals UAE

About Keratoconus

The word Keratoconus comes from two Greek words: kerato (cornea) and konos (cone). Keratoconus is a degenerative disorder of the eye in which the shape of the cornea, which is usually round, is distorted and develops a cone-shaped bulge, resulting in reduced vision. Keratoconus is a relatively common condition. It affects one person in two thousand, occurs around the world and is quite common in the Middle East.
Progression of Keratoconus depends on the patient’s age at the time of onset and the severity of eye rubbing. The earlier the onset, the faster Keratoconus may progress. The condition always affects both eyes and is asymmetric, so one eye may be more affected than the other.

Causes

Keratoconus has many causes and it results in a cornea that is more elastic than normal and that starts to thin and bulge forward, causing reduced vision and increases astigmatism. It can be inherited and a chromosomal link has been identified. Keratoconus can be associated with other allergic diseases such as hay fever, eczema and asthma but we are not born with it and its onset usually happens around puberty. It is strongly associated with eye rubbing which can also make it progress rapidly. It is also seen in contact lens wearers.
For the best outcome, Keratconus should be detected and treated early. Early detection is possible by generating computerized corneal shape and thickness measurements through corneal topography, using advanced technology such as a pentacam machine. If left untreated, Keratoconus could lead to significant visual impairment and blindness.

Symptoms

blurry and distorted vision
increased nearsightedness or astigmatism (when your eye cannot focus as well as it should
Not being able to wear contact lenses. They may no longer fit properly and they are uncomfortable

Spectacles: These can provide good vision in the early stages of the condition and usually help to correct myopic astigmatism.
Hard or Scleral Contact Lenses: When spectacles don’t work, rigid contact lenses and Scleral lenses usually provide very good vision if the patient can tolerate them; they should be fitted by a contact lens specialist.
CXL – Corneal Collagen Cross linking with Riboflavin (Vitamin B2): This technique increases the strength of the cornea and prevents the progress of Keratoconus.
Intracorneal Rings (Intacs & Ferrara): These rings inserted into the cornea change the shape of the corneal cone, flattening it and making it a more regular shape and more central. This will help improve the vision in majority of patients. We use it when patients cannot tolerate contact lenses and while the cornea is still clear and the condition is not very advanced. A Femto-second laser is used to create the tunnel and the entry point for the rings, which has made it a very safe and reliable procedure.
Toric Implantable Contact Lenses: For those who have stable Keratoconus and good vision with glasses, Toric Implantable Contact Lenses are generally used (some time after stabilizing the Keratoconus with corneal cross linkage) to improve corneal shape with an intracorneal ring or with very limited therapeutic Eximer laser correction. The Toric ICL can eliminate the need for optical aids altogether and in some patient’s results in improved vision and balance between the two eyes.
Phototherapeutic Keratectomy (PTK): Keratoconus patients are not candidates for Lasik or normal laser correction, however some patients benefit from limited eximer laser correction to improve the surface irregularity of the cornea, when
contact lenses cannot be tolerated. PTK is always combined with corneal cross linkage, undertaken either during the same procedure or afterwards.
Corneal Transplants: Corneal Transplants are used in the advanced stages of Keratoconus, when there is corneal scarring. The procedure is either a partial thickness (Deep Anterior Lamellar Keratoplasty = DALK) or full thickness graft (Penetrating Keratoplasty = PK). The need for corneal grafts is declining because of the increasing success in the early diagnosis of Keratoconus and the effectiveness of corneal cross linkage to stabilize the condition, so Keratoconus generally does not reach the advanced stage.

Keratoconus Specialists

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Dubai
Abu Dhabi

Dr. Miguel Morcillo

Consultant Ophthalmologist in Cornea, Cataract and Refractive vision correction surgery

Dr. Miguel Morcillo is a Consultant Ophthalmologist specialising in Cornea, Cataract and Refractive (Vision Correction – LASIK, LASEK, TransPRK) Surgery at Moorfields Eye Hospital Dubai in Dubai Healthcare City. Dr. Miguel holds a Spanish Degree in Medicine from the Universitat de Valencia. He completed his Residency in Ophthalmology under the MIR (Medico Interno Residente) system of the Spanish Ministry of Health. He has more than 25 years of experience, most of which was attained in Spain. He also worked in Italy and finally moved to the UAE in 2017 and has been practising in the UAE since that time. Dr. Miguel started his career working with Clinica Baviera, the largest private ophthalmology group in Europe, in Madrid and Valencia. He helped develop many of the refractive treatments offered today, such as LASIK, LASEK, ICLs and multifocal IOLs, in addition to collaborations with other hospitals to provide high-quality cataract and refractive surgery to patients. Dr. Miguel trained in cornea surgery at NIIOS Eye Institute (Rotterdam) and, since then became an experienced educator for other surgeons in the fields of the anterior segment and refractive surgery. He has been a member of “Surgical Eye Expeditions International” since 1999, an American non-government organisation that arranges eye camps worldwide. Dr. Miguel has assisted several eye charity camps in numerous countries of Africa, in addition to Peru, Panama and India, providing free eye care and performing surgeries to those who could not afford it in less developed areas. His research efforts include surgical topics and outcomes such as Ultrathin LASIK, Keratoconus screening, ICLs, and multifocal IOLs, among others. He has presented various papers in national and international congresses and journals and organised educational courses on refractive surgery for peers and opticians. He is a member of Sociedad Española de Oftalmologia (SEO), the Panamerican Association of Ophthalmology (PAAO) and the European Vitreoretinal Society (EVRS). He is also the recipient of the Dr. P C Mahendra Memorial ACOIN International Award in India in recognition of his charitable work with people in need.

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Dr. Nadim Habash

Consultant Ophthalmologist in Cornea and Ocular Surface Diseases

Dr. Nadim Habash is an American Board-Certified Consultant Ophthalmologist specialising in Cornea, Ocular Surface Diseases, and General Ophthalmology at Moorfields Eye Hospital Dubai in Dubai Healthcare City. Dr. Nadim undertook his speciality training at George Washington University in Washington D.C., U.S.A., where he also served as Chief Resident. He then acquired an additional Cornea and External Disease Fellowship at the University of Florida, Gainesville, U.S.A. Dr. Nadim is a Diplomate of the American Board of Ophthalmology and a Fellow of the Royal College of Surgeons of Canada FRCS(C). Over the past 40 years, Dr. Nadim has had extensive experience in Corneal transplantation and Anterior Segment Diseases in several countries, including the United States of America, the Kingdom of Saudi Arabia and the United Arab Emirates. Dr. Nadim has worked and held leadership and academic positions in prestigious institutions, including the University of Ohio at Toledo, Ohio, U.S.A., the King Faisal Specialist Hospital and the King Khaled Eye Specialist Hospital in Saudi Arabia, and at the American Hospital Dubai, where he held key positions including Chief of Medical Staff, Assistant Chief Medical Officer and Director of Ophthalmology. Dr. Nadim published several papers about Corneal transplantation, chaired many scientific conferences and symposia, and participated actively in teaching medical students and Ophthalmology residents. Throughout his career, Dr. Nadim held memberships in several scientific organisations, including a fellowship of the American College of Surgeons, the American Academy of Ophthalmology membership, and many regional and local societies

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Dr. Osama Giledi

Consultant Ophthalmologist in Cataract, Cornea and Refractive Vision Correction Surgery

Dr. Osama Giledi is a Consultant Ophthalmologist specialising in Cornea, Cataract and Refractive Surgery at Moorfields Eye Hospital Dubai in Dubai Healthcare City. Dr. Osama is skilled in managing ocular surface problems, including severe dry eye and Stem cell deficiency. He performs small incision phacoemulsification for his cataract surgery and is experienced in using toric and multifocal premium intraocular lenses. Dr. Osama’s expertise in managing complex corneal conditions includes all types of modern corneal graft procedures, such as DALK and DSAEK. He has performed over 23,000 refractive surgeries, including Lasik, LASEK, Intralase LASIK and Trans PRK, and phakic IOLs. He delivers the latest treatment for keratoconus, including Intracorneal ring segments, corneal cross-linking and complex laser treatment. Dr. Osama graduated from Libya and completed his ophthalmic training in the UK, attaining a Fellowship in Ophthalmology from The Royal College of Edinburgh in 1996. He completed two years of higher subspecialty training fellowship on the anterior segment, Cornea and refractive surgery in 2003 at the prestigious Corneoplastic Unit and Eye Bank at Queen Victoria Hospital, East Grinstead. He worked as a Consultant Ophthalmologist at the Centre for Sight London and the Corneoplastic Unit and Eye Bank at Queen Victoria Hospital. Dr Osama has 22 years of experience in the UK, providing services for anterior segment, Cornea, Refractive and cataract surgery. In addition to his clinical commitments, Dr. Osama has extensive experience in teaching and training; he is a noted presenter at national and international meetings and has extensive research published in peer-reviewed scientific journals. He is a member of the Royal College Surgeons of Edinburgh, the United Kingdom & Ireland Society of Cataract and Refractive Surgeons, and the European Society of Cataract and Refractive Surgeons.

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Dr. Imad Hakim

Consultant Ophthalmologist in Cataract and Refractive vision correction surgery

Dr. Imad Hakim is a Consultant Ophthalmologist, specialised in Cataract and Refractive vision correction surgery at Moorfields Eye Hospital Dubai in Dubai Healthcare City. He holds a graduate degree from the University of Aleppo in Syria, obtained in 2002. Dr. Hakim also holds a certificate in Ophthalmology from Ludwig Maximillian University of Munich, Germany. He undertook his sub specialty training in Cataract and Refractive surgery at Realeyes Eye Clinic in Munich, Germany. His areas of expertise are in Femto laser assisted Cataract Surgery (FLACS), Refractive vision correction surgery (LASIK, LASEK, TransPRK, PTK, Implantable Contact Lenses ICLs, Multifocal Intraocular Lenses IOLs and Add-On IOL ), Keratoconus, Phototherapeutic Keratectomy (PTK) Laser Eye Surgery and General Ophthalmology. He has more than 15 years of regional and international experience in countries including Germany and UAE. In his career, he has practiced in leading medical institutions such as Realeyes Eye Clinic in Munich, Germany as well as American Hospital in Dubai, U.A.E. He has published research papers on Cataracts and Retina in leading journals. He is a member of the European Society of Cataract & Refractive Surgeons (ESCRS), The German Committee for Refractive Surgery (KRC), Commission of the German Ophthalmological Society (DOG) and Professional Association of German Ophthalmologists (BVA).

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Dr. Esmaeil Arbabi

Medical Director and Consultant Ophthalmologist in Corneal transplant, Cataract & Refractive Surgery

Dr. Esmaeil Mohammad Arbabi is a Consultant Ophthalmologist with excellent surgical experience including all types of corneal transplants (DMEK, DSAEK, PDEK, DALK, PKP), ocular surface reconstruction, complex cataract and laser refractive surgery. Prior to joining Moorfields Eye Hospital Center, he was Consultant Ophthalmic Surgeon (Cornea, Cataract & Laser Refractive Surgery) and the Lead for Refractive Services at Royal Liverpool University Hospital, Liverpool, United Kingdom. Dr. Esmaeil holds several prestigious degrees and certifications in the field of cataract and refractive surgery including MSc in Cataract and Refractive Surgery, Certificate in Laser and Refractive Surgery (CertLRS) from Royal College of Ophthalmologist and Fellow of European Board of Ophthalmology Subspecialty Diploma in Cataract and Refractive Surgery (FEBOS-CR). He is a member of Royal College of Ophthalmologists, European Society of Cataract and Refractive Surgeons, European Board of Ophthalmology, UK Cross-Linking Consortium, EYE -LAW CHAMBERS - Medicolegal Expert and Expert, Association of Personal Injury Lawyers (APIL). He is instrumental in high quality papers in various peer reviewed journals and numerous scientific and ophthalmology publications. He is also an examiner for the University of Leeds and the University of Liverpool and for the European Board of Ophthalmologist (FEBO exam).

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