We Now Offer Keratoconus Treatment in Our Rockville Center Office
May Prevent Need for Corneal Transplant
Cross-Linking Procedure Can Halt Corneal Changes, Preserve Vision
Corneal collagen cross-linking, a recent FDA-approved treatment for the eye disease keratoconus, can preserve vision and prevent the need for a corneal transplant.
Until recently, people with keratoconus had few treatment options. The best their eye doctors could offer was increasingly stronger eyeglasses, special contact lenses, and eventually, in many cases, a corneal transplant. In spring 2016, the FDA approved a new treatment for this condition, called collagen cross-linking, or CXL, and this treatment is now available at Visionary Eye Doctors, one of the few ophthalmology practices in the DC metro area to offer the FDA-approved Avedro KXL system in our center.
“Corneal cross-linking is beneficial to my patients in that it offers them a therapeutic option to limit the progression of keratoconus and corneal ectasia following refractive surgery,” says J. Alberto Martinez, MD. “The FDA approval of corneal cross-linking with Photrexa products and the KXL System offers new treatment options for appropriate patients who, until now, had few options to help with their vision challenges and with little to no therapeutic treatment for these sight-threatening conditions.”
“Early diagnosis is critical and allows patients to be treated at the onset of the disease,” states Dr. Martinez, “Patients suffering from progressive keratoconus and corneal ectasia following refractive surgery can now receive a therapeutic treatment that has been rigorously tested and approved.
How Does Keratoconus Treatment Work?
The treatment uses vitamin B2 (riboflavin) plus ultraviolet light to strengthen the collagen, a fibrous protein that supports the structure of your cornea. It’s performed on an outpatient basis and takes about an hour and a half.
The ophthalmologist removes the outer layer of cells (epithelium) from your cornea using a special instrument, then places riboflavin drops in your eye. Next, UV light is shone on the eye to activate the riboflavin and stiffen your cornea. Healing typically takes five to seven days, while you wear a bandage contact lens.
Additionally, we also offer Prokera Ring insertion after CXL to promote epithelial healing, reduce inflammation in the eye, and prevent corneal haze development.
Cross-Linking Stops Keratoconus from Progressing
Collagen cross-linking isn’t a cure for keratoconus, however, it is able to halt further progression of the condition. Most importantly, it can help slow visual deterioration and prevent the need for a corneal transplant.
This treatment changes the intrinsic biomechanical properties of the cornea and has been shown to strengthen the cornea by around 300%. While the procedure is comparatively recent, research to date indicates that it is very effective in both slowing disease progression and improving vision.
The results over periods of 3 and 5 years of a Dresden clinical study have indicated that in the case of 60 eyes researched, the progression of keratoconus had been stopped in all cases. In 31 of the eyes, there was a reversal, and flattening of the cornea and visual acuity was improved. Similar success was found in a later study in which 281 eyes were observed for up to 6 years following the procedure. Only 2 of the patients showed signs of any further progression of the disorder, and they both responded successfully to re-treatment.
So, it appears that many people who may have faced the serious option of undergoing a corneal transplant as a result of keratoconus may now have new hope that this can be avoided. Equally, they may be able to retain a much higher standard of visual quality for a much longer period of time.
The primary goal is to stabilize your corneas, to keep them from getting worse. That can help you avoid a corneal transplant, which is a major surgery that carries significant risks, including rejection of the donor tissue.
Benefits to Patients
- Only FDA-approved therapeutic treatment available for progressive keratoconus and corneal ectasia following refractive surgery
- Targets the root of the problem. Can limit the progression of the disease by stiffening the cornea
- Clinical benefits of reduction in maximum corneal curvature (as measured by Kmax)
- Minimally invasive and offers long term benefits
Who Is a Candidate for Cross-Linking?
Our ideal candidates are in the younger age spectrum — up through their 50s. The FDA has approved the procedure for people ages 14 to 65.
You may not be able to have cross-linking treatment if your cornea is too scarred or too thin, or if you have an active infection or a problem with the surface of your eye, such as severe dry eye.
Does Insurance Cover Corneal Cross-Linking?
Until recently, most insurances did not cover corneal cross-linking, however, insurers are coming on board. Currently, in this area the insurers that now cover CXL are:
- Care First, Blue Cross Blue Shield
- Independence Blue Cross – Maryland
- Johns Hopkins Healthcare of Maryland
Our practice is proud to offer patients the first and only therapeutic products for corneal cross-linking which have been FDA approved to treat progressive keratoconus and corneal ectasia following refractive surgery.