Using crosslinking to treat keratoconus

Keratoconus is also known as pellucid and is a progressive disorder that causes the cornea to become thinner and steeper.  This results in a person’s vision being distorted and havingan increased sensitivity to glare and light.


To strengthen the cornea, doctors can perform an in-office procedure known as corneal cross-linking.  The procedure is relatively simple.  It involves applying riboflavin (vitamin B2) to the eye’s surface and following it up with a controlled application of ultraviolet light.


Depending on an individual case, the thin outer layer of the eye, the epithelium, may or may not be removed to facilitate the application of the riboflavin.  Crosslinking is generally most effective before the cornea has become too irregularly shaped or there has been a significant amount of vision loss.


Crosslinking has also been shown to be effective in treating corneal infections, especially those that have not responded to topical antibiotics.


Crosslinking can be done by itself, but in many cases, it is combined with other treatments to fight the effects of keratoconus.


In some cases, small arc-shaped corneal implants call Intacs are installed to help reshape and stabilize the eye.  This is more likely to happen in severe cases of keratoconus.


Although the procedure has been performed more than 200,000 times, it has not been approved by the FDA in the United States.  Patients who want to undergo this treatment can have the procedure done by participating in a clinical trial that evaluates the safety and efficacy of crosslinking.  And, because it has not been FDA approved, crosslinking is generally not covered by insurance.


For those who have had crosslinking, studies have shown that it is effective in 99 percent of patients who either remain stable or show improvement in the shape of their cornea.


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