Corneal Cross-linking

Corneal Cross-Linking for Keratoconus

Patients who have distorted vision due to Keratoconus or Ectasia now have a new treatment option recently approved by the FDA. As of April, 2016 Corneal Crosslinking has been added to the other approved treatments available for those with corneal issues.

Dr. James Kelly is now offering this remarkable new treatment for patients with Keratoconus and for those who have developed the rare LASIK complication Ectasia.

There are currently multiple treatments available for Keratoconus. Patients can wear rigid gas permeable contact lenses, they can have plastic Intacs inserted into the cornea, or they can have corneal transplant surgery.

Corneal Collagen Crosslinking has been performed around the world for over ten years and has been in clinical trials here in the US for some time. The US clinical trial results yielded not only a halt in the bulge caused by Keratoconus, but in addition, a mild reversal of the condition. The results were so successful that the FDA has now approved its use to treat Keratoconus.

The first and only FDA approved treatment for progressive Keratoconus.

Patients with distorted vision from Keratoconus can be treated at Kelly Laser Center and achieve these same great results.

What is Corneal Cross-Linking

Corneal Crosslinking is commonly referred to as Collagen Crosslinking, Corneal Collagen Crosslinking, and CXL.

When a patient develops Keratoconus their cornea becomes progressively weaker and thin causing the cornea to bulge into a conical shape. The result is blurry and distorted vision and high levels of astigmatism and myopia. This condition usually develops at an early age when a patient is in their teens and twenties.

Corneal Crosslinking uses a combination of Vitamin B2 riboflavin solution and UV light to cause the chemical bonds of the cornea to link or “knit together.” The collagen layers bond together and strengthen or “stiffen” the cornea.

Early intervention with a Corneal Crosslinking treatment does not cure the condition, but stops its progression and strengthens the cornea.  The treatment is more effective for patients with early to moderate Keratoconus making early diagnosis key. It can arrest the progression and prevent further visual deterioration.

In more advanced cases of Keratoconus, patients may be treated with a combination of Corneal Collagen Crosslinking and Intacs to stabilize the cornea and prevent the condition from worsening.

The Corneal Cross-Linking Procedure-Two Approaches

Trans-Epithelial Cross-Linking – This approach to corneal Crosslinking is performed with the outer most layer of the cornea or the epithelium left in place.

Epithelium Off – An alternate approach is to remove the epithelium completely similar to PRK surgery before applying the riboflavin solution.

In either case the rest of the procedure is similar. It is completed in the office and patients go home immediately afterward.

Before the Procedure

Although the vast majority of patients with Keratoconus will be candidates, all patients still must undergo an evaluation.  Dr. Kelly will measure the depth of the cornea and perform a topographical map of its surface along with a complete eye exam.

Contact lenses must be removed for a prescribed period of time prior to the evaluation and the procedure.

During the Corneal Cross-Linking Procedure

  • Anesthetic drops are administered to prevent any discomfort during the treatment.
  • A painless eyelid holder is used to prevent blinking.
  • The yellow solution of riboflavin or Vitamin B2 is dripped onto the intact cornea until it has soaked the cornea.
  • After the cornea is sufficiently saturated, a controlled amount of UV light is applied which activates the riboflavin. The amount of application time depends upon each patient’s individual condition but usually no longer than 30 minutes.
  • The entire treatment takes approximately 1 to 1.5 hours to complete.
  • Most patients only need one treatment

After the Procedure

  • Patients will use anti-inflammatory and antibiotic drops after the treatment. The medications promote healing and prevent the possibility of infection.
  • A contact lens will be placed on the eye for protection and patients will return for several follow up appointments.
  • Patients can expect some discomfort the first day or two, but healing time is fast with the trans-epithelial approach.
  • Most patients will need a new prescription and may be able to wear soft contact lenses and glasses more comfortably and safely.

Benefits of Corneal Cross-Linking

The goal of Crosslinking is to bond together the collagen fibers in the cornea to strengthen it, stop the thinning and prevent any further loss of vision. It gives patients another choice to improve their vision without resorting to an invasive surgery.

Improvement in visual function occurs within several weeks, with no haze and few complications. As with any surgical procedure, there are risks and possible complications.  Dr. Kelly will discuss individual risks and benefits with each patient.

This newly approved treatment gives those patients with Keratoconus an opportunity to improve their vision without uncomfortable contact lenses or invasive surgeries like corneal transplants.

Kelly Vision Center will always remain on the forefront of technology, and Corneal Collagen Crosslinking is no exception.

Dr. James Kelly provides diagnosis and treatment for Keratoconus and other corneal issues. Experience the Kelly difference and trust your care to the professionals at Kelly Vision Center.

Contact Kelly Vision Center if you or someone you know would like to schedule a consultation for Corneal Crosslinking.