Patients who suffer from progressive keratoconus face the prospect of gradually dimming vision, as well as multiple corneal transplant surgeries to replace a thinning, cone-shaped cornea. The U.S. Food and Drug Administration has approved an effective treatment that, while new to American patients, has been used by eye surgeons in Europe for nearly two decades.
It’s called corneal crosslinking, and it repairs the cornea by stimulating collagen production in corneal tissue. As an experienced ophthalmologist with the Schwartz Laser Eye Center, Dr. Jay Schwartz has already performed hundreds of these procedures, providing new hope and clear vision to patients who have long struggled with this disabling condition.
The Gold Standard
In the medical literature, epi-off corneal crosslinking is often referred to as “the gold standard” in keratoconus treatment.
“Epi” is an abbreviation for the epithelium, the outer layer of the cornea. During the surgery, this surface is removed and riboflavin eyedrops are applied to the newly exposed tissue. After approximately 30 minutes, during which time the riboflavin fully penetrates the eye, ultraviolet light is targeted on the area to trigger the production of collagen to fortify the cornea, halting the progression of keratoconus and preventing future loss of visual acuity. The “links” that result from crosslinking are the collagen fibers that will grow and strengthen, stabilizing corneal structures. The entire in-patient procedure takes about an hour and a half; and because your eyes will have been numbed, you will feel no pain.
Weighing the Benefits
Corneal crosslinking will typically not reverse the effects of keratoconus, but it is the only proven technique for stopping its progression. A corneal transplant is the only other treatment option.
An alternative crosslinking approach called “epi-on” corneal crosslinking keeps the epithelium intact. This has the advantage of shortening recovery time and reducing the discomfort you will feel during healing. There is less chance of infection, and less likelihood that you will experience corneal haze or clouding.
Recovery from an epi-off procedure takes several weeks, but you may be able to resume normal activities in a week or less. Your vision will require more time to sharpen, however; and you may experience blurriness for several months.
To promote healing, you will wear a soft contact lens for each affected eye and apply antibiotic and steroid drops as Dr. Schwartz advises. You will also need pain medication for the first few days.
If you would like to learn more about corneal crosslinking, schedule a personal consultation with experienced ophthalmologist Dr. Jay Schwartz at his Glendale or Scottsdale office by calling or emailing Schwartz Laser Eye Center today. If you choose this effective surgical solution, it will be performed by Dr. Schwartz in the Scottsdale office.
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