Corneal Crosslinking for Keratoconus
Written by Shannon Wong on September 24, 2020
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. In recent years, an innovative new solution has become available:
This technique repairs the cornea by stimulating collagen production in corneal tissue. Experienced Austin Eye ophthalmologists have performed hundreds of corneal crosslinking procedures, providing new hope and clear vision to patients who have long struggled with the disabling effects of keratoconus.
Collagen’s Healing Power
Although there are various approaches to corneal crosslinking, the “epi-off” technique is considered the gold standard in keratoconus treatment.
“Epi” is simply the prefix of 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 directed at 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.
The “Epi-On” Option
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. However, epi-on is not as effective as epi-off at stopping the progression of keratoconus.
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. You will also need pain medication for the first few days.
If you would like to learn more about corneal crosslinking or keratoconus, we invite you to schedule a personal consultation with one of the board-certified ophthalmologists at Austin Eye. Contact us by calling our North office at (512) 250-2020 or our Central office at (512) 454-2020.