Collagen Crosslinking

CORNEAL COLLAGEN CROSS-LINKING WITH VARIABLE ENERGY – EPI-ON (NEW)

Corneal cross-linking is the newest, FDA-APPROVED, approach toward treating Keratoconus (and other Ectasias), and we have it available in-house for our patients who suffer from irregular corneas.

During this procedure, Dr. Soroudi applies Riboflavin drops (Vitamin B) onto the Cornea (clear part of the eye that has become distorted) and exposes the eye to an ultraviolet (UV) light source. This is LITERALLY like sitting in a tanning bed (except he’ll keep your eye open with a gentle speculum so you won’t have to be worried about blinking). This causes the loose, “floppy” cornea to become more “stiff” (without causing it to scar!). The entire procedure takes about 15 minutes in-and-out.

A Cornea Soaked with Riboflavin

Dr. Soroudi is experienced at doing this procedure WITHOUT removing the “skin” of your Cornea (Epithelium) – hence the expression “EPI-ON” (vs. epi-off). This significantly reduces the pain and irritation after the procedure. Speeds up recovery, and most importantly, the chance of an infection!

Corneal cross-linking is currently the only treatment that can stop progressive keratoconus from getting worse. And it may help you avoid a corneal transplant, which is a major surgery.

Types of Corneal Cross-Linking

There are two types of cross-linking: epi-off and epi-on. (“Epi” is short for epithelium, the thin surface layer of the cornea.)

With epi-on approach, Dr. Soroudi loosens your epithelium with eyedrops before he puts the eyedrops in and has developed a technique to make sure the Riboflavin drops “get into” the cornea before the UV exposure (otherwise it won’t work).

Who Should Get Corneal Cross-Linking?

Dr. Soroudi only recommends Corneal cross-linking if you’re YOUNG (less than 35 years of age)! Dr. Soroudi doesn’t suggest this procedure for patients older than 35 as their Corneas are usually stable and don’t change anymore.

MOST of our patients have been told that this procedure will “improve their vision!” This is not true! The procedure doesn’t reverse changes that have already happened — it just keeps them from getting worse. As a result, Dr. Soroudi almost always supplements this procedure with Intacs, PRK, and other modalities to not just stabilize your vision, but to also IMPROVE IT!

How to Prepare

Basically, on the day of your procedure, take a normal shower in the morning and don’t wear make-up. Dr. Soroudi suggests you use a warm compress with baby shampoo scurb to achieve good ocular hygiene (you can purchase his eye-presses from CVS or online at www.eye-press.com) or use a warm towel.

You do not need to come with an empty stomach.

You’ll also need someone to drive you home after your procedure, although we do allow people to take a taxi/uber, etc.

With the epi-on procedure, recovery is usually painless. You’ll be able to go about your regular activities as soon as the next day.

Your Vision After Corneal Cross-Linking

With epi-on technique, you vision is typically back to baseline within a day or two. You will notice changes in your vision as your cornea heals. You may be more sensitive to light and have blurry vision for about 1-3 months after the surgery.

Although the mail goal of corneal cross-linking is to slow your disease and prevent future vision problems, in some cases, your eyesight does get better over time.

Risks

Like most surgeries, epi-off corneal cross-linking can sometimes cause problems, such as:

    • Infection
    • Sesitivity to light
    • Eye pain or swelling
    • Damage to the Cornea or Epithelium
    • Blurred vision, hazy vision, or other vision problems

Such problems are rare with Epi-on cross-linking, and that’s why Dr. Soroudi prefers this approach. If done correctly, it should be just as effective as the painful Epi-off technique.

Dr. Soroudi’s actual patient undergoing Collagen Cross-linking with the all new PXL Platinum 330 unit with eye-tracking technology

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