Crosslinking Keratoconus Explained

When the front part of your eye, the cornea, thins and becomes weaker with time; it can produce a bulge in the shape of a cone. As a result, your vision becomes distorted, making it hard to see properly.

To treat this condition, doctors will use eye drops and ultraviolet light to make the corneal tissues stronger which stops the bulge from getting worse. The term crosslinking is used because the drop and the UV light add additional bonds between the fibers in your eye, working like cross beams to help stabilize the cornea.

This is a relatively new procedure, and was approved by the FDA in 2016. Right now, it is the only known treatment that can stop keratoconus from getting worse, helping many patients avoid major surgery in the form of a corneal transplant. The procedure doesn’t reverse corneal changes that have already taken place, but it does keep them from getting worse. There are some instances where eyesight actually improves over time.

What to Expect If You Have the Procedure

To prepare, your doctor will probably tell you to not wear contacts for a couple of weeks leading up to the procedure. You will also be told if there are any foods or medicines you should avoid as well.

During the procedure, you will receive drops to numb your eyes and another medicine to relax you. This will be followed by vitamin B2 eye drops that will allow your cornea to better absorb light. The actual procedure will take 30 to 60 minutes.

There are two variations of the procedure. The epi-off procedure involves removing the protective epithelium layer on your eye before drops are put in. This allows more drops to be absorbed, but it does take longer to recover and there is more risk of infection. The epi-on procedure means the epithelium is left alone, resulting in less risks and a shorter recovery.

For the epi-on procedure, recovery is usually painless and you can return to your normal activities within a day or so. The epi-off procedure is much aggressive and it could take you as long as 5-7 days before you can get back to your routine. You will also need to wear a soft contact lens for a week and use antibiotic and steroid drops during the recovery period.

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