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Corneal Surgery

Keratoconus: We Offer Two Solutions

Corneal Cross-linking:

First and Only FDA Approved Therapeutic Treatment for Progressive Keratoconus

Corneal collagen cross-linking, also known as KXL or CXL, is a newly FDA-approved procedure that helps treat keratoconus by stabilizing the cornea to prevent it from getting weaker and thinner.

What is Keratoconus?

Keratoconus is a condition in which the cornea becomes weak and begins to change shape, becoming steeper, like a cone. The condition causes distorted vision, categorized as high astigmatism.

Most patients are diagnosed with keratoconus in their teens or 20s, and it is a progressive disease. As the condition progresses, patients may need a rigid contact lens or a corneal transplant.

Keratoconus can result in severe astigmatism, and light sensitivity and can cause the patient’s prescription to change with every eye exam.

What is Corneal Cross-linking?

Corneal cross-linking (CXL) is the latest treatment for keratoconus. It involves the administration of Vitamin B2 drops (riboflavin) to the cornea, and then the cornea is exposed to ultraviolet light. CXL causes the bonds in the cornea to strengthen and ultimately stops the progression of keratoconus.

First, the patient receives anesthetic drops, then the surgeon gently removes the corneal epithelium (the outer layer of the cornea). Riboflavin drops are applied for 30 minutes, and a special UV light is administered for up to 30 minutes. After the procedure, a bandage contact lens is placed, and the patient is seen the next morning.

Patients experience mild to moderate pain for the first few days as the epithelium heals. The contact is removed about a week after the procedure, and the vision is blurry during that time. There is some fogginess to the vision for the first month, and then the clarity will return.

We treat one eye at a time, and the interval between procedures can range from 1-3 months

Who is a good candidate for corneal crosslinking?

A good candidate for corneal cross-linking is a patient with mild-to-moderate keratoconus who has good vision in their current glasses or contacts. The goal of corneal crosslinking is to stop the progression of the condition, which it does successfully in over 94% of patients. Crosslinking does not eliminate the need for glasses or contacts.

Corneal crosslinking can stop the progression in the vast majority of patients, but it does not return the cornea its shape before developing keratoconus.

Insurance may cover the procedure if you have a documented progression in your keratoconus, but this differs between different providers.

If you would like to learn more about cross-linking or find out if you’re a candidate, please schedule your complimentary eye exam and consultation with us today!


What are INTACS?

INTACS are thin rings that are inserted into the cornea to improve its shape. Imagine that they are like rods in a tent that give it rigidity and a dome-like shape. The main goal of INTACS is to stop the progression of keratoconus. They do not obviate the need for contacts or glasses, but in the vast majority of cases, they do STOP the progression of keratoconus.

They also can “soften” the astigmatism (or cone) for a patient and make it easier for them to wear contact lenses. INTACS can be combined with crosslinking.

Imagine your keratoconic cornea as a tent with a curved top. If the sides are pushed out, the top is flattened slightly and the dome shape is restored. Placing Intacs in the periphery of the cornea flattens the center by restoring the natural dome shape of the cornea to improve vision.

Who is a good candidate for INTACS?

A good candidate for INTACS is a patient with mild-to-moderate keratoconus who is unhappy with their contacts and glasses. In general, INTACS can reduce one’s astigmatism by half, and more importantly, stop the progression of keratoconus.

How is the INTACS procedure performed?

The procedure is performed with mild sedation and topical anesthesia. The procedure lasts about 15 minutes, and we perform them on Thursday. Generally, the patient can return to work on Monday, and they have only 1 to 2 days of a mild scratchy feeling and some soreness that can be relieved with ibuprofen or Tylenol.

Intacs are clear inserts designed to reshape the cornea to correct vision. They are made of a material that has been safely used in contact lenses and cataract surgery for over 50 years. Intacs cannot typically be felt nor seen as they remain below the surface of the cornea. The procedure does not require any needles or shots, only numbing drops.

Intacs are now FDA-approved for keratoconus. Benefit of Intacs is potential for improved vision and risk potential is infection, inflammation, and glare among others.

Patient Testimonial

“I feel like I have a huge weight lifted off me now that I don’t have to wear contacts or glasses.”