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CORNEAL COLLAGEN CROSS LINKING

Corneal Cross Linking In Medford

Corneal Cross Linking is an FDA approved treatment for Keratoconus and other irregularities of the cornea. These are complex medical conditions that can begin with mild symptoms like nearsightedness and advance over time with symptoms such as blurry vision, distortions and halos, shadows and ghosting. Once detected during a comprehensive eye exam, it is important to seek treatment from a Cornea Specialist. Cataract and Laser Institute has a Cornea Specialist and Cornea Surgeon on staff in Medford. All treatment begins with a Consultation. Schedule an Appointment today at (541) 779-2020.

Treatment Options For Keratoconus And Corneal Ectasia:

Treatment of Cornea conditions such as advanced Keratoconus or Ectasia (which occurs as a result of LASIK or Photo Refractive Keratectomy [PRK] surgery) may require a surgical procedure. Corneal Collagen Cross-Linking (CXL) is one such procedure that is FDA approved and provides some distinct advantages over the traditional Corneal Transplant

What Is Corneal Collagen Cross-Linking?

Corneal collagen cross-linking (CXL) is the standard of care for the treatment of early to moderate Keratoconus or Ectasia.1 It is a minimally invasive, outpatient procedure that combines eye drops and ultra-violet A (UVA) light to strengthen a weakened or irregular shaped cornea. In keratoconus and corneal ectasia, disease or previous surgery can damage the collagen in the cornea causing it to lose its shape and begin to bulge. It is the corneal collagen that holds the cornea in “normal” shape. After the cross-linking procedure, new collagen fibers in the cornea are “Cross-linked” with existing fibers for added strength and stability. This is achieved with a combination of Riboflavin (Vitamin B) eye drops and targeted UVA rays.

Corneal Collagen Cross-Linking

Corneal cross-linking creates new corneal collagen cross-links. This results in shortening and thickening of the corneal collagen fibrils and leads to stiffening and strengthening of the cornea. This in turn prevents further progression of ectatic corneal diseases like Keratoconus.

Riboflavin

Riboflavin (vitamin B2) is important for body growth, red blood cell production and assists in releasing energy from carbohydrates. Its food sources include dairy products, eggs, green leafy vegetables, lean meats, legumes, and nuts. Breads and cereals are often fortified with riboflavin. Under the conditions used for corneal collagen cross-linking, riboflavin 5’- phosphate, vitamin B2, functions as a photo-enhancer which enables the cross- linking reaction to occur.

Ultra-Violet A (UVA)

UVA is one of the three types of invisible light rays given off by the sun (together with ultra-violet B and ultra-violet C) and is the weakest of the three. A UV light source is applied to irradiate the cornea after it has been soaked in the photo-enhancing riboflavin solution. This cross-linking process stiffens the cornea by increasing the number of molecular bonds, or cross-links, in the collagen.

What To Expect With Corneal Collagen Cross-Linking?

Cross-linking is an outpatient procedure, which means you go home the same day of the surgery. Here’s what to expect:

  • With the patient in a reclined position, eye drops will be administered to numb the eyes. This ensures that no discomfort is experienced throughout the procedure.
  • The Cornea Surgeon will remove a thin outer layer of the Cornea called the Epithelium. This will allow the medication to penetrate deeper into the cornea.
  • Riboflavin (Vitamin B2) eye drops are applied to the cornea for a period of about 30 minutes.
  • UVA light rays are directed at your cornea. The light activates the riboflavin in the cornea and this helps form new bonds between the collagen fibers in your cornea.
  • In order to help the cornea heal, a protective contact lens is placed over the eye for a period of about a week.

Recovery From Corneal Cross Linking

A return to normal daily activities after Corneal Collagen Cross Linking (CXL) surgery usually takes about 1-2 weeks. During the first month after CXL surgery, the vision may fluctuate.

One week after surgery it’s important NOT to:

  • use eye makeup
  • be in places that are smoky or dusty
  • touch or rub your eyes
  • get water in your eye (you may shower, but no swimming)

If your bandage contact lens placed on the day of surgery falls out or becomes dislodged, you should not replace it. Throw the contact lens away and contact your physician.

In the unlikely event of severe eye pain, or a sudden change/loss of vision a patient should call their doctor immediately.

Treatment: Corneal Cross Linking, Long Beach

All treatment begins with a Consultation with a Cornea Specialist in the Cataract and Laser Institute of Southern Oregon in Medford. Schedule an Appointment today at 541-779-2020.

  1. Gomes, José P., Donald Tan, Christopher J. Rapuano, Michael W. Belin, Renato Ambrósio, José L. Guell, François Malecaze, Kohji Nishida, and Virender S. Sangwan. “Global Consensus on Keratoconus and Ectatic Diseases.” Cornea 34.4 (2015): 359-69. Web.
  1. Beshwati IM, O’Donnell C, Radhakrishnan H Biomechanical properties of corneal tissue after ultraviolet-A- riboflavin crosslinking. J Cataract Refract Surg. 2013;39(3):451-62. Doi:10.1016/j.jcrs.2013.01.026.