Keratoconus Treatment with Corneal Cross-Linking Treatment
Corneal cross-linking is a technique that was first used in 1998 to treat patients with a disease called keratoconus. In keratoconus, the cornea (the front clear window of the eye) can become weak, thin, and irregularly shaped. Instead of keeping their normal round shape, corneas with keratoconus can bulge forward into the shape of a cone causing poor vision. Corneal cross-linking is now being performed for Ohio patients with this condition in approximately 450 centers throughout the world. Through a research study, our practice is now able to provide this investigational treatment to our patients using advanced technology for cross-linking.
What Is Keratoconus?
Keratoconus is a common disease that occurs in approximately 1 in 750 Americans. In this condition, the cornea becomes weak, progressively thinner, and irregular in shape which can cause high levels of astigmatism. Instead of a normal, relatively round shape resulting in clear vision, the cornea with keratoconus can become cone-shaped. This can interfere with the ability to see clearly. Often keratoconus patients first require glasses, then contact lenses, and, if the condition progresses to a severe level, a corneal transplant may be required.
What Is Astigmatism?
Astigmatism is when the front surface of the eye (the cornea or clear window in front of the eye) is less round and more irregular in shape so the image won’t focus clearly on the retina in the back of the eye. This can result in poor vision and glare.
What Does Corneal Cross-Linking Treatment Do?
Normal corneas have crosslinks between their collagen fibers that keep them strong and able to retain their normal shape. In keratoconus, the cornea is weak with too few cross-links or support beams. This weakened structure allows the cornea to bulge outwards. The cross-linking procedure adds cross-links or “cross beams” to the cornea, making it more stable, holding its shape, and focusing power better. These new cross-links help strengthen the cornea which stops the thinning process and further loss of vision.
How Effective Is Corneal Cross-Linking Treatment?
Many research studies have shown that corneal cross-linking treatment may prevent further vision loss in over 95% of patients and improves vision in 60-81% of patients treated.
Common Questions about Corneal Cross-Linking Treatment
1. Wollensak G, Spoerl E, Seiler T.; Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus. AJO 2003 May;135(5):620-7
2. Raiskup-Wolf F, Hoyer A, Spoerl E, Pillunat LE.; Collagen crosslinking with riboflavin and ultraviolet-A light in keratoconus: long-term results. J Cataract Refract Surg. 2008 May;34(5):796-801.
3. Coskunseven E, Jankov MR 2nd, Hafezi F.; Contralateral eye study of corneal collagen cross-linking with riboflavin and UVA irradiation in patients with keratoconus.
J Refract Surg. 2009 Apr;25(4):371-376
4. Grewal DS, Brar GS, Jain R, Sood V, Singla M, Grewal SP.; Corneal collagen crosslinking using riboflavin and ultraviolet-A light for keratoconus: one-year analysis using Scheimpflug imaging. J Cataract Refract Surg. 2009 Mar;35(3):425-32.
5. Spoerl E, Mrochen M, Sliney D, Trokel S, Seiler T.; Safety of UVA-riboflavin cross-linking of the cornea. Cornea. 2007 May;26(4):385-9.
6. Trattler W, Rubinfeld R, Corneal Collagen Cross-linking; Cataract and Refractive Surgery Today; September 2009
7. Caporossi A, Mazzotta C, Baiocchi S, Caporossi T. Long-term Results of Riboflavin Ultraviolet A Corneal Collagen Cross-linking for Keratoconus in Italy: The Siena Eye Study. Am Journal of Ophthalmology 2010:149:585-593 www.ajo.com/article/S0002-9394(09)00808-3/abstract
8. Raiskup-Wolf F, Hoyer A, Spoerl E, Pillunat LE. Collagen crosslinking with riboflavin and ultraviolet-A light in keratoconus: long-term results. J Cat Ref Surg. 2008
9. Vinciguerra P, Albè E, Trazza S, Seiler T, Epstein D. Intraoperative and postoperative effects of corneal collagen cross-linking on progressive keratoconus. Arch Ophth. 2009
10. Daley, R. Cornea
Cross-linking vision improvement evidence mounts. Eyeworld, 2010. http://www.eyeworld.org/article.php?sid=5268&strict=&morphologic=&query=Daley, R. Corneal%26%238232%3BCross-linking vision improvement evidence mounts.
11. Rubinfeld RS, Trattler WB, Martin NF, Adi MA and The CXL-USA Study Group: Answering Your Patients’ Questions About Cross-Linking; Advanced Ocular Care. March 2010:25-28
12. Boxer Wachler BS, Pinelli R, Ertan A, Colin CKC. Safety and efficacy of transepithelial crosslinking (C3-R/CXL), J CATARACT REFRACT SURG – VOL 36, Pgs 186-187, JANUARY 2009
13. Pinelli R, El Beltagi T, Leccisotti A. Update on Corneal Crosslinking. Cataract and Refractive Surgery Today October 2008: 67-69. http://www.crstodayeurope.com/Issues/1008/1008_19.php