Corneal Collagen Cross-Linking for Keratoconus and Post-LASIK Ectasia

Our main specialty at Kirkwood Eye Associates is the treatment and management of Keratoconus. We offer the latest in visual correction through our scleral lens prosthetic devices that offer patients with this condition the ability to see clearly with all day comfort and consistency.

Until now, keratoconus management revolved around offering the best possible vision combined with careful monitoring of the progression. What was lacking was the ability to treat the condition itself, as keratoconus is a progressive disease that can result in the need for full corneal transplantation. Recently, the FDA approved a procedure known as corneal collagen cross-linking (C3R or CXL). This procedure, performed for over a decade in other developed countries around the world, is a safe and non-invasive treatment that aims to stop the progression of the disease in its tracks.

CXL involves applying riboflavin (vitamin B2) to the cornea and exposing it to ultra violet light A (UVA), resulting in a reaction that strengthens the corneal tissue thereby stoping the
progression of thinning and protrusion seen in keratoconus and post-LASIK ectasia. The procedure lasts 30-60 minutes and has a relatively fast recovery time. While it does not correct the corneal shape, it does stop it from getting worse and therefore preserves best-corrected visual acuity and greatly reduces the risk of corneal transplantation.

The procedure is very safe and well tolerated and it is recommended for most any keratoconus patient under the age of 45, and a patient at any age who has post-LASIK ectasia. Because the cornea naturally cross-links with age, patients over 45 who show stable topography may not need CXL. The UVA light is absorbed by the cornea and the riboflavin. This is important because it can be harmful to the posterior cell layer of the cornea (the endothelium) if it is able to penetrate that far. For this reason, patients with corneas that have become excessively thin may not be good candidates for the procedure, although drops can be added prior to treatment to temporarily swell the cornea to a safe thickness.

CXL does not cure keratoconus and those who are dependent on visual correction devices such as gas permeable lenses, hybrid lenses or scleral lenses will most likely continue to need these after the procedure is completed. Still, the stabilization will help to ensure that functional vision will always be possible and that the risk of corneal transplant is greatly diminished. To see if you would benefit from this new and exciting treatment option, contact Dr. Andrew Biondo and the team at Kirkwood Eye Associates for evaluation today. Combined with the revolutionary scleral lens systems for visual rehabilitation, normal visual function is more obtainable than ever before for patients with keratoconus and post-LASIK ectasia.