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The UK’s leading Centre of Excellence for Keratoconus Treatment and Innovation

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Patient Stories

Our Approach

Led by Mr. Marwan Ghabra—a distinguished ophthalmic surgeon with over 30 years of experience and creator of the innovative “Ghabra Technique” for keratoconus treatment —​our team focuses on understanding your unique vision goals.

We provide clear, jargon-free information to help you make informed decisions about treatments like LASIK, Trans PRK, SMILE, and PTK, addressing conditions such as short-sightedness, long-sightedness, astigmatism, and presbyopia.

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Types of Keratoconus Treatments

We believe the best treatment is prevention of the disease by early diagnosis for high myope and high astigmatism and seeking laser refractive surgery. Once a diagnosis is made, staging is important to allow for determining progression and if there is any hormonal imbalance.

At The Harley Street Eye Centre, we offer a wide spectrum of advanced treatments for keratoconus, carefully tailored to the stage and severity of your condition. From minimally invasive techniques to vision-enhancing surgical procedures, our goal is to protect your sight and improve your quality of life — including offering The Ghabra Technique, a revolutionary procedure developed here exclusively.

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Xenia Collagen Implants

Exclusive to The Harley Street Eye Centre, the Ghabra Technique is a pioneering approach to keratoconus surgery that offers a minimally invasive, biomechanically precise alternative to corneal transplants.

Developed by Dr. Marwan Ghabra, this technique uses the Xenia collagen implant—a biocompatible, lenticule-shaped disc or ring segment—designed to restore corneal thickness, improve shape, and correct irregularities in both the front and back surfaces of the cornea. Each Xenia implant is customisable, with its dimensions tailored to match the unique corneal profile of each patient, ensuring a highly personalised and precise treatment outcome.

What makes the Ghabra Technique pioneering is its use of a femtosecond laser to create a deep corneal pocket, allowing for the precise placement of the implant within the deeper layers of the cornea. This approach enables surgeons to directly target posterior corneal irregularities—the very area where the earliest signs of keratoconus typically appear. Previously, addressing this region was only possible through more invasive procedures such as corneal transplant surgery.

The result? A stronger, more symmetrical, and visually optimised cornea, with faster recovery times and improved patient comfort.

CXL is the first line of treatment for slowing or stopping keratoconus progression. It works by applying riboflavin drops (vitamin B2) to the cornea, followed by UV light exposure, which increases collagen bonds and stabilises the cornea.

There are two main types of crosslinking:

  • Standard CXL involves removing the outer layer of the cornea to allow full penetration of the drops.
  • Accelerated CXL shortens UV exposure time for a faster treatment with similar outcomes.

Both techniques help stabilise vision and can be combined with other treatments for enhanced results.

 For carefully selected patients, a combined approach using topography-guided laser treatment alongside corneal cross-linking (CXL) can offer both visual rehabilitation and long-term disease stability. The laser component gently reshapes the front surface of the cornea to reduce irregularities and improve vision, while the cross-linking treatment strengthens the corneal structure to halt further progression of keratoconus.

This dual-procedure is particularly valuable in cases where patients have not previously undergone cross-linking, as laser correction alone is not considered safe or effective for keratoconus. When performed together, the result is a more stable, regular corneal surface with reduced dependence on contact lenses and enhanced visual outcomes

ICRS are tiny, arc-shaped implants placed within the cornea to flatten and regularise its shape. They work by reducing corneal steepness.

These ring segments are especially useful for patients with moderate to advanced keratoconus who are no longer achieving clear vision with glasses or contacts.

The procedure is minimally invasive, and reversible.

When the keratoconic cornea becomes too thin, leading to other treatments not being implemented a corneal transplant may be required.

There are two main surgical approaches:

  • Deep Anterior Lamellar Keratoplasty (DALK): Replaces only the damaged outer layers of the cornea.
  • Penetrating Keratoplasty (PK): A full-thickness corneal transplant where the entire cornea is replaced with donor tissue.

While highly effective, these procedures involve longer recovery periods and carry a risk of rejection, which is why they are typically reserved for advanced cases. long term monitoring and aftercare. with potential for follow on procedures.

 Implantable Collamer Lenses (ICLs) offer a safe and effective solution for improving vision in keratoconus patients, particularly those who are contact lens intolerant or seeking greater visual independence. Unlike standard laser vision correction, ICLs do not alter the shape of the cornea—making them especially suitable for individuals with stable keratoconus.

ICLs are placed inside the eye, behind the iris and in front of the natural lens, to correct refractive errors such as high myopia or astigmatism—common in keratoconus. The procedure is minimally invasive and reversible, offering excellent visual quality, often with sharper contrast and reduced glare.

For keratoconus patients who have already undergone corneal stabilisation through cross-linking or other structural procedures, ICLs can provide an additional layer of visual enhancement. In select cases, they may also be combined with other interventions, such as collagen implants or topography-guided treatments, to deliver a truly customised outcome.

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Is Keratoconus affecting your vision?

If you’re experiencing persistent vision issues, it’s essential to recognize the signs and explore effective treatment options.​

  • Do you often see halos or ghosting around lights
  • Are you needing frequent changes in your glasses or contact lens prescription?
  • Do you find yourself constantly rubbing your eyes?
  • Has your NHS doctor only offered contact lenses as your treatment option?
  • Do you struggle with poor night vision or have increased sensitivity to glare?
  • Are you experiencing distorted or blurred vision, especially in just one eye?
  • Do you suffer from eye strain or visual fatigue, especially after tasks that require focus?
  • Are your contact lenses becoming uncomfortable or difficult to wear?
  • Have you tried multiple non-surgical treatments without success?

If any of these challenges sound familiar, it might be time to explore a lasting solution.

Who is Eligible for Trans PRK?

Determining your suitability for Trans PRK laser eye surgery involves several key factors.

Cross
Linking		 PRK PTK Xenia ICL Transplant
Progressive Keratoconus ✓ ✓ ✗ ✓ ✓ ✓
Irregular Astigmatism ✓ ✓ ✗ ✓ ✓ ✓
Corneal Thickness > 400 µm ✓ ✓ ✓ ✓ ✓ ✓
Requirement for Reversible Procedure ✗ ✗ ✗ ✓ ✓ ✗
Contact Lens Intolerance ✓ ✗ ✗ ✓ ✓ ✓
Advanced Keratoconus Not Responding to Other Treatments ✗ ✗ ✗ ✓ ✓ ✓

International Patients

If you live outside the UK and are considering Laser Eye Surgery, our international booking team are happy to assist

Our team of laser surgeons are multilingual, experienced in working with patient short on time and through their vast network of international colleagues, keeping an eye on your follow up has never been easier. 

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How Much Does Keratoconus treatment Cost?

At The Harley Street Eye Centre, we believe in providing clear and straightforward information about the costs associated with keratoconus treamtments. Our goal is to make vision correction accessible and affordable, ensuring you have all the necessary details to make an informed decision.​

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Comprehensive

Eligibility

Assessment

From

£1,500

Per Eye

Flexible

Installments

0% Interest

Our Treatment Process

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1

Complimentary Eligibility Assessment

2

Pre-Treatment

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Treatment

4

Aftercare

Keratoconus FAQs

Is Keratoconus treated on the NHS?

Yes, the NHS does offer treatment for keratoconus, primarily aimed at halting progression in mild to moderate cases—most commonly through corneal cross-linking (CXL). However, the availability of this treatment varies significantly between NHS hospitals, and waiting times can be unpredictable. Vision correction options, especially for more complex cases, may be limited.

According to NICE guidelines, corneal cross-linking should be offered promptly once keratoconus is diagnosed to prevent further deterioration of vision. In private care, patients often benefit from quicker access to treatment, more consistent availability, and advanced technologies tailored not just to stabilise the condition, but to optimise visual outcomes as well.

While keratoconus cannot be completely prevented, early diagnosis and proactive care can significantly reduce the risk of progression. Avoiding eye rubbing, managing allergies, and having regular eye exams—particularly if there’s a family history—are key steps. Accessing timely treatment, such as corneal cross-linking, can help preserve vision in the long term.

Keratoconus is believed to result from a combination of genetic and environmental factors. Common triggers include a family history of the condition, chronic eye rubbing, allergic eye disease, and certain connective tissue disorders. Managing these risk factors, especially eye rubbing and allergies, plays an important role in slowing progression.

The prevalence of keratoconus varies significantly across different regions and populations. While earlier estimates suggested it affected approximately 1 in 2,000 individuals, more recent studies indicate higher rates. For instance, a 2017 study in the United States reported a prevalence of about 1 in 375 individuals. In the Middle East, the condition appears even more common; research from Saudi Arabia found a prevalence of approximately 1 in 21 patients (4.79%), and studies in Lebanon reported rates around 3.3%. These variations may be attributed to genetic, environmental, and methodological factors. Given this variability and the potential for underdiagnosis, especially in early stages, regular eye examinations are crucial for early detection and management.

Keratoconus can vary from mild to severe. In early stages, it may cause only minor vision distortion, but if left untreated, it can lead to significant thinning and irregularity of the cornea. This can result in serious visual impairment and, in some cases, require corneal transplantation. Early diagnosis and modern treatments like corneal cross-linking can dramatically reduce the risk of progression and help preserve quality of life.

Although keratoconus cannot be reversed, its effects can be managed very effectively. Vision can often be improved with custom or scleral contact lenses, while progression can be halted with corneal cross-linking. In advanced cases, surgical options like intracorneal ring segments or corneal transplantation may be considered. With personalised treatment, many patients achieve excellent functional vision.

Treatment for keratoconus generally falls into two main categories: halting disease progression and correcting vision.

To stop progression, the first-line treatment is corneal cross-linking (CXL)—a minimally invasive procedure that strengthens the corneal structure and aims to prevent further deterioration.

For vision correction, a variety of options are available depending on the stage and severity of the condition. These include:

  • Xenia® collagen corneal implants

  • Topo-guided laser treatments

  • Intracorneal ring segments (ICRS)

  • Specialist contact lenses (such as scleral or hybrid lenses)

  • Corneal transplantation in advanced cases

In many instances, your ophthalmologist may recommend a combination of treatments from both categories to stabilise the condition while also improving visual function. Private care settings often provide access to the full spectrum of these advanced options, along with highly customised treatment plans tailored to each patient’s unique needs.

Keratoconus very rarely leads to complete blindness. However, if left untreated, it can cause significant visual impairment, especially in both eyes. In the most advanced stages, vision may be severely reduced and no longer correctable with glasses or standard lenses. With today’s treatments—including corneal cross-linking and customised lens options—most patients retain useful vision and lead full, active lives.

Keratoconus typically begins during the teenage years or early 20s. It tends to progress more rapidly in younger individuals and usually stabilises by the mid-to-late 30s. Because progression is often silent in the early stages, early detection and intervention are key to maintaining long-term visual function.

Absolutely stop rubbing your eyes. Eye rubbing is strongly linked to the progression of keratoconus and can lead to further corneal thinning and deformation. If your eyes feel itchy or irritated, speak to your eye specialist about treating underlying causes such as allergies or dry eye. Managing these issues can help reduce the urge to rub and protect your corneal health.

Traditional laser eye surgery procedures like LASIK are not suitable for patients with keratoconus and may worsen the condition. However, some advanced techniques—such as topography-guided PRK combined with corneal cross-linking—may be used in selected cases to improve vision. These specialised treatments are generally available in private clinics with expertise in keratoconus management.

Yes, most people with keratoconus can live entirely normal and fulfilling lives. With modern treatment options, vision can often be stabilised and significantly improved. Some lifestyle adjustments may be needed, especially around vision correction, but with good management, many patients continue to drive, work, and enjoy all their usual activities.

People with keratoconus often describe their vision as distorted, blurred, or doubled—particularly in low light or at night. This visual disturbance, commonly referred to as “ghosting,” causes overlapping or shadowed images, especially around text or lights. Halos, glare, and starbursts around lights are also frequent complaints. These symptoms result from the irregular shape of the cornea affecting how light enters the eye. Early diagnosis and treatment can significantly reduce these effects and help restore clearer, more comfortable vision.

If left untreated, keratoconus typically worsens over time—especially in younger patients. As the cornea thins and becomes more irregular, vision deteriorates, and glasses may no longer provide adequate correction. In advanced stages, scarring can develop, and corneal transplantation may become necessary. Early intervention, particularly with corneal cross-linking, can prevent these outcomes and preserve vision.

Keratoconus usually affects both eyes, although it often presents asymmetrically—meaning one eye may be more advanced than the other. In rare cases, only one eye shows signs of the disease at first, but the second eye often develops changes over time. Regular monitoring of both eyes is important, even if symptoms seem isolated to one.