Corneal Cross Linking

At the Waring Eye Institute, we are involved in advanced research and development of eye disease treatments. We offer patients suffering with progressive keratoconus a highly-effective procedure called “corneal cross linking.” Patients with progressive keratoconus or post-LASIK ectasia (a rare side effect of laser eye surgery) may be excellent candidates for this treatment. Called “CXL,” the procedure can resolve the advance of vision loss associated with corneal degeneration. As the collagen structure within the eye weakens in keratoconus, the cornea develops a cone-like shape. Keratoconus typically develops between the ages of 10 to 20 years of age, with many patients discovering the condition as vision rapidly worsens. The progression naturally stops advancing when patients are in their 40s.

Treatment to Halt the Progression of KC

CXL treatment is most often used to halt the progression of keratoconus. While many patients may achieve improved eyesight, this is a secondary goal of the procedure. CXL works to strengthen the collagen layer in a section of the cornea (called stroma) through a specialized procedure in which the eye is “soaked” with a solution of riboflavin and then exposed to UV light. The treated eye is often bandaged with a specialized contact lens which is later removed. You will be given several eyedrops to apply during the day at intervals during recovery.

Candidates for Corneal Cross Linking

Keratoconus is not a rare condition. The frequency of the disease is estimated to be one in every thousand people. Most often, keratoconus starts in childhood, typically between the ages of 10 and 25 years of age. Vision tends to worsen at varying speeds – but often quickly - with the disease progressing until reaching the forties. A younger person who is suffering with progressive keratoconus should be evaluated to determine if CXL is an appropriate treatment to halt the advance of the disease. Some patients who have experienced problems after LASIK surgery may also be candidates.

FDA Approved Treatment: Corneal Cross Linking

While corneal cross linking has been used as an effective treatment in Europe for years, FDA approval for CXL to treat keratoconus and post-LASIK ectasia was only achieved in April of 2016.

CXL Treatment: What to Expect

The treatment itself is very easy to tolerate and essentially pain-free. The procedure involves the following steps:

You will be placed in a reclined position for the procedure.
Riboflavin drops are initiated.
You will be tested to determine if a sufficient quantity of riboflavin has been absorbed.
Anti-inflammatory and antibiotic drops are prescribed, which you will apply on a specific schedule during healing.
The thickness of your cornea will be checked, and the UV light applied for a specific length of time, which can be up to 30 minutes.
A bandage contact lens may be applied to protect the eye’s surface.

How Does Corneal Cross Linking Work?

The treatment involves applying liquid vitamin B12 (riboflavin) to the cornea, followed by exposure to UV light. This procedure strengthens the collagen fibers in the eye so they will no longer continue to shift into the cone-like shape associated with keratoconus. Dr. George Waring IV has been involved in research studies to improve the CXL procedure, testing new riboflavin formulations and using the most advanced CXL treatments. As a leader in new developments in ophthalmology, Dr. Waring offers his patients a full range of the most advanced treatments for keratoconus and ectasia in his luxurious, state-of-the-art eye clinic serving patients throughout the areas of Charleston, Myrtle Beach, Columbia, and the surrounding communities.

The Journey is the Reward

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