Corneal Crosslinking
At the Cornea and Cataract Consultants of Orlando (CCCO) Center for Excellence for Keratoconus, we are dedicated to all aspects of keratoconus care. From our advanced diagnostic tools to our customized specialty contact lenses and cutting-edge surgical techniques, we strive to provide the most comprehensive and state-of-the-art treatment for keratoconus.
Effective communication among our providers is crucial in managing keratoconus. Our doctors and staff work collaboratively to develop tailored treatment plans that aim to prevent disease progression and optimize your vision. Your care is our top priority, and we are committed to guiding you through every step of your journey.
How are we different?
Above and Beyond
Care
When you choose to trust your vision to our team, we are committed to addressing all your keratoconus needs. From the beginning to the end of your journey, you will receive care from our highly experienced specialists in keratoconus. At CCCO, we take pride in taking the time to explain your treatment options and answer all your questions during each visit. We recognize that everyone has unique circumstances, and we make it a priority to understand your individual visual needs.
Customized Treatment Approach
At CCCO, keratoconus patients undergo comprehensive examinations using the latest technology. We create tailored treatment plans to stabilize the cornea, improve its shape, and correct long-term vision. Our cutting-edge surgical options focus on these goals. While not every patient needs all treatments, thorough evaluation is essential. Our experienced doctors perform a wide range of procedures, ensuring each patient receives an optimal treatment plan designed specifically for their needs. Your vision is our priority.
What Is Corneal Crosslinking?
Corneal Crosslinking (CXL) is a treatment designed to strengthen the cornea in patients with keratoconus and other corneal ectatic disorders. CXL is a minimally invasive surgical procedure designed to enhance the structural integrity of the cornea. It primarily targets conditions such as keratoconus and corneal ectasia, which are characterized by progressive thinning and abnormal shaping of the cornea. As these conditions develop, the cornea can assume a more conical form, leading to significant visual distortion, increased sensitivity, and the risk of vision loss.
What Are the Potential Benefits of Corneal Crosslinking?
- Stabilization of the cornea, preventing further progression of keratoconus.
- Improvement in visual acuity and quality of vision.
- Reduction in the need for contact lenses or glasses.
What should I expect with Corneal Crosslinking?
The primary goal of CXL is to halt the progression of thinning, weakening, and irregular shaping of the cornea. While CXL can stabilize the cornea and may even lead to improvements in vision, it cannot restore the cornea to its original state. Patients may find that their vision stabilizes and, in some cases, improves following the procedure. However, it’s important to note that you might still require glasses or contact lenses for optimal near or distance vision. In some instances, the cornea may begin to weaken again over time. If this occurs, additional CXL treatments or alternative corneal surgeries may be necessary. Always consult your eye care professional for personalized recommendations and monitoring.
What are the procedure steps for Corneal Crosslinking?
- Pre-Operative Assessment
- A thorough eye examination is performed, including imaging tests to evaluate corneal thickness and shape.
- The ophthalmologist discusses the procedure, its risks, benefits, and what to expect during recovery.
- Preparation
- The eye is numbed using topical anesthetic drops to ensure comfort throughout the procedure.
- In some protocols, the outer layer of the cornea (epithelium) is removed, while others (transepithelial) do not require this step.
- Riboflavin Application
- A riboflavin (vitamin B2) solution is applied to the cornea multiple times over a period of about 20-30 minutes. This solution helps enhance the effect of the subsequent UV light exposure.
- UV Light Exposure
- After riboflavin absorption, the cornea is exposed to ultraviolet (UV) light for approximately 30 minutes. During this time, additional riboflavin drops are applied to maintain hydration.
- The UV light activates the riboflavin, creating new bonds between collagen fibers in the cornea, thus strengthening its structure.
- Post-Operative Care
- Once the procedure is complete, patients are given instructions for care at home, including the use of prescribed antibiotic and anti-inflammatory eye drops to prevent infection and reduce inflammation.
- A protective contact lens may be placed on the eye to facilitate healing and comfort.
What are the potential risks and complications of Corneal Crosslinking?
- Pain: It’s common to experience pain and light sensitivity for a few days following the procedure. You will be provided with a prescription for medication to help manage any discomfort.
- Infection: There is a risk of developing an eye infection post-surgery, which could lead to scarring of the cornea and worsen your vision. To minimize this risk, you will receive a prescription for antibiotic eye drops. If you have a history of herpes simplex virus (HSV) infections, there is a possibility of recurrence.
- Vision Problems: Expect to experience poor vision for several days or weeks after the procedure. If an infection occurs or if your eye does not heal properly, this impaired vision may persist.
- Corneal Healing: Your cornea may not heal optimally, which could result in cloudiness (corneal scarring) rather than a clear surface. Healing times can vary significantly.
- Shape Changes: The shape of your cornea may continue to change for several months after the procedure. During this time, you might need to update your glasses or contact lenses, and adjustments may be necessary again once the corneal shape stabilizes.
- Effectiveness of CXL: It is possible that CXL may not fully address your condition, and you may require more than one treatment. If the cornea becomes weak, thin, or irregular again, further CXL treatments or alternative corneal surgeries may be needed.
FAQ
Who is a candidate for CXL?
Is the procedure painful?
How long does recovery take?
Will I need glasses or contact lenses after the procedure?
How effective is corneal crosslinking?
Can I have CXL if I’ve had previous eye surgery?
What if my condition worsens after CXL?
What are the alternatives to the procedure?
· Regular monitoring without treatment.
· Contact lenses (rigid or soft) to manage vision.
· Other surgical options such as corneal transplant.
More on Corneal Crosslinking: https://www.aao.org/eye-health/treatments/corneal-cross-linking-2