Can Corneal Cross-Linking Help Slow the Progression of Keratoconus?
What is keratoconus?
Keratoconus is a degenerative eye condition in which the cornea (the thin dome-like tissue covering the eye) morphs into a cone shape. Collagen fibers supposed to support the eye’s structure are weak with keratoconus, causing defects in the cornea’s shape. This affects how the eye perceives light and how the brain may interpret that light. Symptoms of keratoconus include blurry vision and light sensitivity. This condition can occur in patients as young as nine years old, and if left untreated, will get worse over time.
What is corneal collagen cross-linking?
The corneal collagen cross-linking procedure (CXL) is not a cure for keratoconus. Still, it was approved by the FDA in 2016 to improve vision in patients struggling with the condition and halt the progression of the disease.
With CXL, many patients can avoid undergoing a corneal transplant, which is the recommended treatment in the later stages of keratoconus. Research has shown that CXL can halt vision loss in up to 95% of patients and improve vision in 60-81% of those treated.
How does CXL work?
Corneal collagen cross-linking can be performed in about one hour. Your eye doctor will numb the eyes with special drops and then remove the thin layer covering the corneas (the epithelium). Drops of vitamin B2 will then be administered, known to help the corneas better absorb light.
Next, the doctor will shine ultraviolet light into your eyes to help strengthen the corneas. The mixture of ultraviolet light and riboflavin (vitamin B2) increases the chemical bonds between the eye’s collagen fibers and the corneas, preventing further bulging. Special contact lenses customized to your condition may be required after a corneal cross-linking procedure.
What happens after CXL?
For 3-6 weeks after CXL, patients may find that their vision is somewhat worse. This is normal and to be expected as the corneas heal from surgery. Positive changes begin to emerge at around 8-12 weeks post-op, and the vision may continue to improve for 6-12 months after treatment.
What is the takeaway?
While keratoconus presents the unique problem of a slowly bulging corneal surface, corneal collagen cross-linking has proven to be an innovative and effective tool in preventing further deterioration of the corneas and in helping to improve vision for patients who undergo CXL. These sessions are painless and brief and can significantly improve the quality of life for those suffering from keratoconus. Ask your eye doctor today if corneal collagen cross-linking with the FDA-approved technology might be right for you.