Advanced Medicinal Treatment for Keratoconus: A Systematic Review of New Drugs and Formulations

Keratoconus is a progressive ocular disorder characterized by the cornea gradually thinning and protruding into a conical shape, resulting in distorted vision. The underlying pathogenesis of keratoconus is multifactorial and involves a loss of corneal collagen cross-linking, leading to structural instability and the conical deformation of the cornea. Currently, the mainstay treatments for keratoconus include surgical interventions, such as corneal cross-linking, and the use of contact lenses for vision correction. However, there are no approved direct pharmacological treatments available. In this review, we provide an overview of innovative medical therapies that target various pathogenic mechanisms of keratoconus. These treatments aim to enhance collagen cross-linking, reduce corneal degradation, and modulate inflammatory factors. Advances in drug formulations and delivery vehicles have played a significant role in the development of these novel treatments. Some of these therapies are in advanced stages of clinical development, demonstrating promising results, while others remain in preclinical stages. In addition to directly targeting the pathogenesis of keratoconus, preventive measures, such as medical treatments that reduce eye rubbing or mitigate corneal hydrops, have shown potential in halting disease progression and alleviating symptoms. This review aims to update the current landscape of medical treatments for keratoconus, offering insights into future noninvasive therapeutic approaches for managing this condition.