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Cross-Linking: Can it Improve Vision?

November 27, 2023

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Individuals who are living with mild to severe conditions of the eye understand that their quality of life may be diminished. Things such as driving, reading, or cooking may become difficult. Thankfully, advances in the medical field are occurring every day, and the latest advances in cross-linking are a great solution. Read on to learn more about cross-linking and how it may be beneficial to you.

What is Corneal Cross-Linking?

Cross-linking is a medical technique often performed on patients with keratoconus or other corneal diseases, and sometimes on patients with LASIK complications. Keratoconus is a condition that affects the shape of the cornea and causes blurry sight and can be severe if scarring occurs. Often the condition can be treated with glasses or contacts, but some cases require a corneal transplant. The latest advances show that cross-linking can be a great solution. Corneal cross-linking does show promise for stopping or at least slowing the progression of the disease in certain cases at certain stages.

The Corneal Cross-Linking Procedure

Before your procedure, you will need a preliminary eye examination. During this exam, your eye doctor will measure the thickness of your cornea and check your visual acuity and general eye health. The cross-linking procedure takes about 60 to 90 minutes, depending on the method. It consists of applying a specific vitamin (riboflavin) as a drop to the cornea during treatment and using ultraviolet light to induce the cross-linking.

There are two basic types of cross-linking:

  • Epithelium-off Cross-Linking: During this procedure, the outermost layer of the cornea (the epithelium) will be removed. This allows the treatment to penetrate the cornea more quickly and deeply.
  • Epithelium-on Cross-Linking: During this procedure, the epithelium is left intact. This means a longer treatment time but a shorter recovery time.

During epithelial-off crosslinking, you will be placed in a reclining position and your surgeon will remove the epithelial layer of your eye. The riboflavin eye drops will then be applied to your cornea. The UV light is then applied for up to 30 minutes. When finished, a soft contact “bandage” will be placed in your eye while the epithelial layer grows back.

If you are receiving epithelial-on crosslinking, you will be placed in a reclining position and the riboflavin drops will be placed. The UV light will be applied, and then the procedure is over. You will be given topical antibiotics and anti-inflammatory eye drops. Cross-linking may cause some initial irritation, but the surface of the eye will recover within several weeks.

 Studies have shown that cross-linking improves or stabilizes the condition of 99 percent of patients.

The Success of Cross-Linking

The Food and Drug Administration (FDA) approved Avedro Inc.’s corneal cross-linking system (KXL) for the treatment of patients with progressive keratoconus and post-laser in situ keratomileusis ectasia in April 2016. As with many trials in medicine, testing is still being done. Most have great success, and the Keratoconus is slowed or stopped afterward. For a small percentage of patients, the progression of the condition continues. For some, a second round of cross-linking is necessary to achieve effective results. Studies have overall shown that standard cross-linking treatments are safe and stabilize the vision of patients with advanced progressive keratoconus.

Schedule a Consultation

If you are interested in learning more about corneal cross-linking, please contact Anh Nguyen Ophthalmology in Falls Church, VA today. Your first step will be to schedule a consultation appointment with one of our skilled providers.

Sources:

https://eyewiki.org/Corneal_Collagen_Cross-Linking
https://www.aao.org/eye-health/treatments/corneal-cross-linking-2
https://www.aao.org/eye-health/ask-ophthalmologist-q/corneal-collagen-cross-linking-keratoconus
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6507378/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5432710/
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