Corneal Collagen Cross-Linking (CXL)
COLLAGEN CROSS-LINKING FOR KERATOCONUS
WHAT IS KERATOCONUS?
Patients who suffer from keratoconus experience a bulging and protrusion of their cornea in a cone-like shape. This occurs as a result of thinning of the cornea, also called ectasia, and can occur in keratoconus (KC). Altered corneal biomechanics in these conditions not only cause the tissue to protrude at the weakest and thinnest point, but this also significantly decreases the ability to see clearly as the light is bent in a distorted fashion through the irregular cornea.
HOW DOES IT OCCUR?
Ectasia is a result of a genetic predisposition to a weak cornea in combination with environmental factors, the most important of which is eye rubbing.
HOW IS IT TREATED?
In the past, patients suffering from ectasia depended on treatment options such as rigid contact lenses, or high risk procedures such as penetrating corneal transplants. However, these treatment options did not halt the progression of ectasia nor treat the condition at the root cause. The development of corneal collagen crosslinking allows one to treat the underlying weakness of the cornea and stop the disease in its tracks.
HOW DOES CORNEAL COLLAGEN CROSS-LINKING WORK?
Our corneas naturally contain cross-links between collagen fibers in order to maintain shape and strength. Ectasia is a result of not enough of these cross-links to support the cornea, leading to bulging and protrusion. This innovative procedure utilizes a combination of riboflavin and UltraViolet light to create additional cross-links to promote cornea stability and strength. The corneal collagen fibrils are chemically bonded together to halt the thinning process and restore vision acuity. This procedure does not involve surgical incision into the eye or ablation, as it is only minimally invasive. Clinical trials have demonstrated that the strengthening effect is likely permanent.
IS CORNEAL COLLAGEN CROSS-LINKING FDA APPROVED?
The FDA has approved corneal cross-linking for the treatment of keratoconus and ectasia. At the St. Louis Eye Institute, Dr. Fedyk treats patients using the FDA approved protocol, which is the only approach proven through multicentered and long-standing studies to be effective in halting the disease and potentially reverse the impact on the vision. Any patient diagnosed with keratoconus, especially if younger than 40 years old or with worsening disease, should be seen quickly and considered for collagen cross linking before the cornea thins to a degree which would make CXL ineffective.