Our team at The Eye Institute of Utah is excited to announce that we are now offering the long-awaited, FDA-approved Avedro corneal cross-linking treatment for patients with keratoconus and post-LASIK ectasia. For the last several years, corneal cross-linking has only been available in the U.S. through clinical trials, many of which have been offered with the cornea specialists here at The Eye Institute of Utah.
Keratoconus is a progressive eye disease where the front surface of the eye called the cornea becomes thin, causing substantial visual distortion. The eye is normally shaped like a sphere, but with keratoconus, the eye bulges out into a cone-like shape. This may cause irregular astigmatism, progressive myopia, and sensitivity to light and glare. If left untreated, keratoconus may result in the need for cornea transplant surgery. Corneal cross-linking is considered one of the most effective treatments in slowing or halting the progression of keratoconus.
Cross-linking is a minimally invasive treatment that is designed to strengthen the cornea for patients suffering from degenerative corneal diseases such as keratoconus and corneal ectasia. The cross-linking treatment utilizes controlled applications of ultraviolet light and riboflavin (vitamin B2) drops to rebuild collagen. By rebuilding new corneal-collagen bonds, the collagen fibrils become shorter and thicker which stiffens and strengthens the cornea.
The FDA-approved Avedro corneal cross-linking treatment is an “epithelium-off” treatment, which means the thin, outer layer of the cornea called the epithelium is removed prior to the treatment using a dilute chemical solution. Removing the epithelium allows the riboflavin liquid to more easily penetrate the corneal tissue.
Your first step in preparing for corneal cross-linking is scheduling a consultation with an experienced ophthalmologist. During this appointment, your eye doctor will confirm your diagnosis and determine if you’re a candidate for the procedure. You’ll also receive pre-operative instructions and have the chance to ask any questions.
Since you won’t be able to drive after the procedure, please arrange for transportation ahead of time.
Corneal cross-linking is an outpatient procedure, typically performed with local anesthesia. Numbing eye drops will be applied to keep you comfortable throughout the treatment. During the procedure, the outer layer of the cornea (epithelium) is removed to allow riboflavin eye drops to penetrate the tissue. These drops are applied for about 30 minutes, followed by exposure to an Avedro UV light for an additional 30 minutes to help
Trusted Source
What is Cross-Linking?
Glaukos Corporation
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strengthen the cornea
.1
After the procedure, a protective contact lens will be placed on your eye to aid in healing.
After your corneal cross-linking procedure, a bandage contact lens will be placed on the treated eye to protect it during the initial healing phase. Once the numbing drops wear off, it’s normal to experience some discomfort, such as a burning or gritty sensation, along with increased sensitivity to light. These symptoms should gradually improve as your eye heals.
You’ll receive detailed post-operative instructions, including prescriptions for antibiotic and steroid eye drops to support healing and prevent infection. Be sure to avoid rubbing your eyes and keep water, sweat, and makeup away from the area for the first several days. Please arrange for someone to drive you home after the procedure, as your vision may be blurry.
If you have been diagnosed with keratoconus or corneal ectasia, corneal cross-linking may be a suitable treatment. Candidates are usually over 14 years old and in the mild to moderate stages of keratoconus. A thorough eye exam and consultation with an ophthalmologist will determine if you are eligible for the procedure.
No, if both eyes require treatment, they will be treated on separate days. This allows one eye to heal before proceeding with treatment on the second eye.
Yes, studies show that corneal cross-linking is effective at slowing or halting the
Trusted Source
Corneal Cross-Linking: Current USA Status: Report From the Cornea Society
Belin MW, Lim L, Rajpal RK, Hafezi F, Gomes JAP, Cochener B
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progression of keratoconus
.2 While it helps stabilize vision, it’s important to note that the procedure doesn’t reverse existing damage.
No, there is no visible change in the appearance of your eyes following corneal cross-linking. The strengthening of the cornea occurs internally, without affecting the outward look of the eye.
Many insurance companies provide coverage for corneal cross-linking, especially when it is deemed medically necessary for conditions like progressive keratoconus. You can consult with our team to explore your insurance and financing options.
The procedure itself is not painful due to the application of numbing eye drops. Some discomfort, such as burning or grittiness, may occur during the recovery period, but this can usually be managed with over-the-counter pain medication or prescription options if necessary.
For most patients, corneal cross-linking is covered by insurance when it is medically necessary. If you have concerns about the cost, our team can assist you in understanding your payment and financing options.
Sources
1 Glaukos Corporation. What is Cross-Linking? Available: https://www.livingwithkeratoconus.com/what-is-cross-linking/. Accessed September 26, 2024.
2 Belin MW, Lim L, Rajpal RK, Hafezi F, Gomes JAP, Cochener B. Corneal Cross-Linking: Current USA Status: Report From the Cornea Society. Cornea. 2018 Oct;37(10):1218-1225. doi: 10.1097/ICO.0000000000001707. Erratum in: Cornea. 2019 Oct;38(10):e49. doi: 10.1097/ICO.0000000000001901. PMID: 30067537. Available: https://pubmed.ncbi.nlm.nih.gov/30067537/. Accessed September 26, 2024.
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The Eye Institute of Utah Doctors have either authored or reviewed and approved this content.