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Keratoconus: Current Status and Prospects
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Keratoconus: Current Status and Prospects

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: 16 July 2025 | Viewed by 1815

Special Issue Editors

Dr. Uxía Regueiro

E-Mail Website
Guest Editor
1. Corneal Neurodegeneration Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
2. Department of Surgery and Medical-Surgical Specialties, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
Interests: vision science; ocular surface; keratoconus; biomarkers; cell cultures; translational research
Prof. Dr. Isabel Lema

E-Mail Website
Guest Editor
1. Department of Surgery and Medical-Surgical Specialties, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
2. Instituto Galego de Oftalmoloxía (INGO), Complexo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela, Spain
3. Corneal Neurodegeneration Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
Interests: ophthalmology clinical research; corneal ectasias; proteomics; theragnostic; medical contact lenses

Special Issue Information

Dear Colleagues,

Keratoconus (KC), the most prevalent corneal ectasia, is a degenerative disease characterized by progressive weakening, thinning, and protrusion of the corneal tissue. Although it is commonly diagnosed during puberty, the condition can begin earlier, impacting children and young adults and causing great visual impairment and quality of life disability with substantial economic, social, and health repercussions. A major challenge in diagnosing this disease is the current reliance on clinical and imaging techniques that only identify KC when irreversible corneal damage has already occurred. To date, there is no pharmacological treatment to prevent its development in the preclinical stages or curative treatment to reverse its evolution. As for the molecular and genetic fields, the scientific community recognizes the involvement of several processes but without elucidating the primary pathophysiological mechanism that triggers the disease.

For this Special Issue, we invite clinicians and researchers to submit groundbreaking original articles or reviews on keratoconus (KC). We aim to expand the understanding of KC by exploring innovative preventive, diagnostic, and therapeutic approaches. Additionally, we encourage submissions that delve into the significant challenges related to biomarker discovery, personalized medicine, and technological advancements in the field of KC.

Dr. Uxía Regueiro
Prof. Dr. Isabel Lema
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • keratoconus
  • prevention
  • diagnostic
  • biomarker discovery
  • genetics
  • exposome
  • treatment
  • personalized medicine
  • major challenges
  • technological advances

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Published Papers (3 papers)

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Review

18 pages, 570 KiB  
Review
Keratoconus: The Local Manifestation of a Systemic Disease?
by Matteo Pederzolli, Federico Procopio, Beatrice Tombolini, Simone Marra, Massimo De Micheli, Francesco Bandello and Giulio Ferrari
J. Clin. Med. 2025, 14(13), 4587; https://doi.org/10.3390/jcm14134587 - 28 Jun 2025
Viewed by 282
Abstract
Keratoconus (KC) is the most common ectatic corneal disease. In this review, the systemic aspects of the disease are discussed, including patient age, genetics, systemic inflammatory status and immune system dysregulation, atopy and eye rubbing, systemic metabolism, the metabolism of micronutrients (including vitamin [...] Read more.
Keratoconus (KC) is the most common ectatic corneal disease. In this review, the systemic aspects of the disease are discussed, including patient age, genetics, systemic inflammatory status and immune system dysregulation, atopy and eye rubbing, systemic metabolism, the metabolism of micronutrients (including vitamin D), and hormonal balance. The association between KC and metabolic diseases, collagen diseases, and psychiatric conditions is also considered. The evidence that is currently available strongly suggests a systemic predisposition toward KC. The understanding that KC may be the local manifestation of a systemic disease could allow earlier detection/prevention and pave the way for research into new treatments addressing the pathogenetic foundations of KC, rather than limiting intervention to the corneal disease. Full article
(This article belongs to the Special Issue Keratoconus: Current Status and Prospects)
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13 pages, 4679 KiB  
Review
Advances in Intracorneal Ring Segment (ICRS) Implantation for Keratoconus: A Comprehensive Literature Review, Clinical Insights, and Future Prospects
by Pablo Morales and Juan A. Durán
J. Clin. Med. 2025, 14(13), 4454; https://doi.org/10.3390/jcm14134454 - 23 Jun 2025
Viewed by 295
Abstract
Keratoconus is a progressive corneal disorder that causes thinning and irregular astigmatism, often leading to significant visual impairment. In the advanced stages, surgical interventions are necessary to restore corneal shape, improve vision, and enhance contact lens tolerance. Intracorneal ring segments (ICRSs) have emerged [...] Read more.
Keratoconus is a progressive corneal disorder that causes thinning and irregular astigmatism, often leading to significant visual impairment. In the advanced stages, surgical interventions are necessary to restore corneal shape, improve vision, and enhance contact lens tolerance. Intracorneal ring segments (ICRSs) have emerged as a well-established, minimally invasive option that not only improves vision but also has the potential to delay or prevent the need for corneal transplantation in advanced cases. Recent advancements in the ICRS implantation techniques, patient selection, and femtosecond laser technology have significantly improved the precision and safety of these procedures, reducing complications. The ability to customize the ring parameters—such as thickness, arc length, and positioning—enables a more individualized approach, particularly for patients with irregular astigmatism. Artificial intelligence (AI) is also emerging as a promising tool for optimizing ICRS planning and improving patient outcomes. Although still in the early stages, AI algorithms may refine the treatment strategies by analyzing large datasets, improving the patient selection, and predicting long-term outcomes. Corneal Allogenic Intrastromal Ring Segments (CAIRSs) offer a novel alternative to synthetic ICRSs, with advantages like improved biocompatibility and reduced extrusion risk. However, CAIRSs remain an evolving technique that requires further refinement and long-term evaluation to determine the tissue integration, the durability of the refractive outcomes, and the potential for late-onset complications. In conclusion, ICRSs continue to be a safe and effective option for managing advanced keratoconus. Ongoing refinement of the surgical approaches—combined with advancements such as femtosecond laser technology and the integration of AI—will ensure that both ICRSs and CAIRSs remain key components in the therapeutic arsenal for keratoconus, offering sustained visual improvements and the potential to delay or avoid corneal transplantation. Full article
(This article belongs to the Special Issue Keratoconus: Current Status and Prospects)
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27 pages, 914 KiB  
Review
Omics in Keratoconus: From Molecular to Clinical Practice
by Sandra Carolina Durán-Cristiano, Andres Bustamante-Arias, Geysson Javier Fernandez, Alba Martin-Gil and Gonzalo Carracedo
J. Clin. Med. 2025, 14(7), 2459; https://doi.org/10.3390/jcm14072459 - 3 Apr 2025
Viewed by 912
Abstract
Keratoconus (KC) is a progressive ocular disorder marked by structural and functional alterations of the cornea, leading to significant visual impairment. Recent studies indicate that these corneal changes are linked to molecular and cellular mechanisms that disrupt and degrade the extracellular matrix. This [...] Read more.
Keratoconus (KC) is a progressive ocular disorder marked by structural and functional alterations of the cornea, leading to significant visual impairment. Recent studies indicate that these corneal changes are linked to molecular and cellular mechanisms that disrupt and degrade the extracellular matrix. This degradation is influenced by proteinases that contribute to a loss of homeostasis and an imbalance in the antioxidant/oxidative state within the cornea, fostering oxidative stress, inflammation, and apoptosis. Although these biological processes have been identified primarily through molecular biology research, omics technologies have significantly advanced our understanding of the physiological and pathological phenomena associated with KC. Omics studies encompassing genomics, transcriptomics, proteomics, epigenomics, and metabolomics, have emerged as critical tools in elucidating the complex biological landscape of various diseases, including ocular conditions. The integrative application of these studies has demonstrated their potential in personalizing medicine across diverse fields such as oncology, neurology, and ophthalmology. This review aims to describe findings from omics research applied to keratoconus, highlighting the genomic, transcriptomic, proteomic, epigenomic, and metabolomic aspects derived from ocular and other biological samples. Notably, the molecular insights gained from these studies hold promise for identifying biomarkers of keratoconus, which could enhance diagnostic accuracy and therapeutic strategies. The exploration of these biomarkers may facilitate improved management and treatment options for patients, contributing to personalized care in keratoconus management. Full article
(This article belongs to the Special Issue Keratoconus: Current Status and Prospects)
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