Cross Linking for Keratoconus
Keratoconus
A commonly reported dystrophy of the cornea, Keratoconus affects approximately one out of every thousand people. It is in essence a degenerative eye disorder that is characterised by structural changes in the cornea that causes it to thin and adapt a conical shape, as opposed to the gradual curve that is its natural state.
Symptoms of Keratoconus include sensitivity to light and distortion of vision (including multiple images and 'streaking'). This type of corneal dystrophy is typically diagnosed in a patient's adolescent years and reaches its peak in their twenties and thirties. If the condition affects both eyes it can, in time, influence a person's ability to drive or read normally.
New treatment for Keratoconus
Cross-Linking With Riboflavin
Until recently there has been no viable Keratoconus treatment available, and often patients were forced to undergo drastic corneal transplant surgery. A number of clinical studies have demonstrated, however, that progressive Keratoconus and iatrogenic ectasia can be stabilised by means of corneal cross-linking. UV radiation in combination with Riboflavin initiates molecular cross-linking of corneal collagen, resulting in the diminishment or total cessation of corneal thinning. Biomechanical strength of corneal tissue is also improved by this method. Although the treatment is not aimed at improving vision, it stabilises the cornea and prevents further deterioration in vision. After this eye treatment many patients experience improved vision with the help of soft contact lenses and spectacles.
The Procedure
Topical anesthetic will be instilled in the eye which is to be treated. The patient's corneal thickness will be measured to make sure their cornea is thick enough for treatment. If it is too thin, it may be swollen with hypotonic solution. The surgeon will then proceed to remove the superficial epithelial cells of the cornea. Riboflavin drops will be instilled onto the cornea at a rate of one drop every two minutes, for 30 minutes consecutively. After 30 minutes the patient’s corneal thickness will be checked again, after which the UV radiation treatment will be initiated, and we will continue to instill one drop of Riboflavin every two minutes for the duration of the treatment. After 30 minutes of radiation the UV-X system switches of automatically. A bandage contact lens will be placed on the eye for ± six days, and the patient will receive eye drop medication to take for ± six weeks after treatment. During the healing process, the patient's vision will be hazy and they may experience scratchiness, light sensitivity and fluctuating vision. Some patients will need to change their contact lens or spectacle prescription after treatment, as there is often a progressive decrease (or improvement) in myopia and astigmatism following treatment. You will be scheduled for follow-up consultations at regular intervals to monitor the progress.
For further information about Cross-linking with Riboflavin or other Keratoconus treatment available, please feel free to contact us at (021) 9100 300 or at info@eyelaserclinic.co.za
