Corneal collagen cross-linking is a revolutionary technique which uses simple UV light and a vitamin photosensitizer to strengthen chemical bonds in the cornea. The goal of the treatment is to stop the progressive degeneration and irregular changes in corneal shape known as Keratoconus (a form of Ectasia). These changes are responsible for an increase in the anterior and/or posterior curvatures of the cornea, and often lead to very high levels of myopia (near-sightedness) and astigmatism.
Dr. Soroudi’s Actual Patient Undergoing Collagen Cross-Linking
The bases for the currently employed corneal collagen cross-linking techniques were developed in Europe in the late 1990’s; Human studies of UV-induced corneal cross-linking began in 2003, and Corneal collagen cross-linking using riboflavin and UV received FDA approval in 2016.
The primary purpose of crosslinking is to halt the progression of ectasia. The best candidate for this treatment is an individual with a progressive ectatic disease of the cornea (e.g., Keratoconus or LASIK-induced Ectasia).
The first stage of therapy is make riboflavin (a form of Vitamin B) penetrate the corneal tissue. This entails gently removing the thin (5-cell layer-thick) “skin of the cornea (epithelium) using 20% alcohol solution using only topical anesthetic drops (This procedure does NOT hurt in any way). Next, Riboflavin 0.1% (vitamin B2) are placed onto the Cornea and allowed to sink into the exposed tissue. After adequate riboflavin absorption, the patient is positioned with the UV light (typically 365-370um) at a small distance (1-5cm) from the corneal apex for 10 minutes.
Antibiotic drops are given and a bandage contact lens is typically placed for a week to protect to cornea and minimize pain which typically starts after 5 hours from the time of the procedure and lasts 2-3 days. (It feels as if there’s broken glass in the eye with lots of tearing). We provide our patients with topical anesthetic drops to take home for comfort.
The outcome of this procedure has been supported by several well designed randomized controlled clinical trials. The goal of therapy is to either halt or reverse a progressive condition (keratoconus or ectasia), and while this procedure is extremely effective in preventing the progression of the disease, almost all patients STILL require placement of Intacs Rings to improve their vision. This can be performed simultaneously or at a later date, depending on the individual case. Dr. Soroudi combines Collagen Cross-Linking with Intacs AND PRK or even implantable contact lens placement to provide his patients with the BEST uncorrected visual acuity possible.
If you suffer from high myopia with astigmatism, if you’ve been told you do not “qualify” for laser vision correction, if you wear thick rigid gas permeable contacts, and your vision is poor even with your contact lenses and/or glasses, do yourself a favor and make an appointment to visit Dr. Soroudi. We guarantee you that it will be the BEST decision you have ever made.
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