Keratoconus is a progressive eye condition in which the corneal tissue thins and becomes weak. As it weakens, the cornea changes shape from a smooth rounded curve into an irregular cone shape that projects from the eye, causing vision to decline. Without treatment, keratoconus can eventually lead to severe vision loss. At Aloha Laser Vision, eye surgeon Alan Faulkner, MD provides a revolutionary FDA-approved treatment for keratoconus called corneal crosslinking (CXL), which can slow or halt the progression of the disease by strengthening the cornea, improve vision, and potentially prevent the need for corneal transplant in the future. In addition to this minimally invasive CXL procedure, we also offer more traditional treatments for keratoconus, including phakic IOLs, Intacs®, and corneal transplantation.
What Are the Causes of Keratoconus?
There are many theories about the causes of keratoconus, but the exact origins of the disease is unknown. Possible explanations theorize the condition may be rooted in genetics; however, excessive exposure to UV rays, persisting eye irritation, and eye rubbing are also associated with keratoconus. Research has shown that an enzyme imbalance within the cornea may be what causes the corneal tissue to weaken and become more easily damaged by free-radicals.
What Treatments Are Available for Keratoconus?
At Aloha Laser Vision, our eye surgeon provide a full range of treatments for keratoconus, including corneal crosslinking. This procedure can also be used in combination with other effective treatments to provide optimal vision improvement. Options include:
- Corneal crosslinking
- A variety of specialized contact lenses
- Intacs® implants
- Phakic IOLs
- Corneal transplant
Corneal transplant surgery is always a final treatment alternative for advanced keratoconus, typically utilized when other methods have proven to be ineffective or are no longer effective. While corneal transplants can ultimately prevent progression into blindness, it is not considered a viable option early on in the development of keratoconus.
What Is Corneal Crosslinking (CXL)?
Corneal crosslinking is a minimally invasive procedure that can strengthen the cornea to prevent further progression of keratoconus. The added strength from the CXL procedure can stabilize and, in some cases, smooth the shape of the cornea. When a reduction in corneal irregularities occurs, vision may improve and it may become possible for patients to benefit from contact lens treatments which may have been previously unsuccessful. Combining corneal crosslinking with Intacs® or Phakic IOL implants has also proven to be very successful for restoring clearer vision. Patients who receive the best results from CXL typically are in the early to moderate stages of keratoconus before the cornea has had the opportunity to significantly change shape.
What are the Benefits of Corneal Crosslinking?
For those who are good candidates for treatment, there are many advantages to undergoing corneal crosslinking. This advanced procedure:
- Often stops or reverses the progression of keratoconus
- Has minimal associated risks
- Achieves a high rate of success
- Is cost-efficient compared to corneal transplant surgery
- Reduces the need for corneal transplants
- Can be combined with additional treatments to achieve optimal vision improvement
- Provides a biological solution for keratoconus
What Can I Expect During Corneal Crosslinking Treatment?
There are two types of corneal crosslinking procedures: epithelium-off and epithelium-on. These distinctions refer to whether or not the thin superficial layer of the cornea is removed or left intact during the CXL procedure. After mapping your cornea with advanced corneal topography technology and measuring its thickness, your eye surgeon will explain which technique is most appropriate for your unique needs.
To begin, anesthetic drops are applied to numb the eye during the procedure. Then, if you are undergoing epithelium-off CXL, the surgeon will remove the epithelium from the cornea. Next, riboflavin drops are added to the eye and allowed to permeate the cornea until the appropriate level of riboflavin has been absorbed. UV light will then be applied to the eye to activate the riboflavin and complete the procedure.
What Can I Expect During Recovery from Corneal Crosslinking?
Once your procedure is complete, your surgeon will bandage your eye for protection. Anti-inflammatory and antibiotic eye drops are usually prescribed to mitigate irritation and prevent infection. Patients are advised to take about a week off from work to heal properly after CXL. It usually takes approximately four to five days for the epithelium to regenerate (if you have had the epithelium-off procedure) and vision typically stabilizes within two to four weeks after the procedure. If you notice very slight haziness in your vision at first, this is normal and it typically dissipates completely as the cornea continues to heal. Your surgeon will advise you on when it is appropriate to begin wearing contact lenses again.
If you have been diagnosed with keratoconus and want to learn more about corneal crosslinking treatment, we encourage you to contact Aloha Laser Vision to schedule a consultation.