This treatment is effective to halt the progression of cornea ectasia (e.g. keratoconus, post LASIK ectasia, etc). At times, the treatment can be successful in improving cornea shape and vision. Please see the Keratoconus section under Conditions to understand the rationale behind this treatment in keratoconus.
Mukhtar Bizrah believes that the 400um limit to being able to perform this treatment is outdated, especially with the advances in technology and understanding of treatment mechanisms. At the AI Vision Clinic, we use advanced technology to enable collagen cross-linking of corneas with advanced level of disease.
After comprehensive assessment of the cornea, the eligibility and treatment options for cornea collagen cross-linking will be discussed with you in more detail.
About keratoconus and corneal ectasia
DALK or Deep Anterior Lamellar Keratoplasty is a type of partial thickness corneal transplant surgery. Instead of removing the entire layer of the cornea, partial removal of the cornea until the Descemet’s membrane is done. The endothelium is left intact.
DALK was initiated to decrease the risks associated with the complete removal of the cornea, such as cornea graft rejection. DALK is performed in corneal diseases affecting the front part of the cornea, such as keratoconus or cornea scarring.
Types of Collagen Corneal Crosslinking
There are two types of collagen corneal crosslinking- Epithelium-off and epithelium-on corneal crosslinking. Epithelium-off cross linking involves removing the topmost layer of the cornea, the epithelium to allow better penetration of the riboflavin drops. On the other hand, Epithelium-on corneal crosslinking involves leaving the epithelial layer intact during the application of riboflavin. This treatment process is less invasive than epithelium-off and is also called transepithelial crosslinking. But there are other treatment methods like Accelerated corneal crosslinking using UV radiation at an increased rate or contact lens-assisted corneal crosslinking using an ultraviolet barrier-free contact lens soaked with riboflavin for the effects.
Ideal Candidate for Collagen Corneal Crosslinking Treatment
The ideal candidate for collagen
- must Be older than 14 years as that is the FDA approved age
- Have progressing irregular astigmatism not improving satisfactorily with glasses
- Have steadily worsening symptoms of keratoconus like corneal ectasia, blurred vision, and halos around the eyes
- Must show a progressively thinning cornea in the Corneal Topography chart towards the center
- Have been declared unfit for LASIK surgery and be willing to follow the physician’s instructions required for successful treatment of the cony
If you want to ensure your eligibility for Corneal Crosslinking, visit AI Vision Clinic, London, for a follow-up.
Before corneal crosslinking treatment
Before the treatment, you will need a screening program where the surgeon will do a visual examination using a slit lamp biomicroscope along with checking your visual acuity with or without glasses. A retina evaluation using an ophthalmoscope will be a part of the screening procedure to rule out any retinal abnormalities before the treatment. Next, diagnostic tests like keratometry will be done to determine the overall corneal curvature with an endothelial cell count to evaluate the thickness of the endothelium. Also, you can expect corneal topography and pachymetry to evaluate the overall shape and thinning of the cornea. Irrespective of the clinic you visit in London, these would be some common tests before getting started with your corneal crosslinking treatment.
During corneal crosslinking treatment
Corneal Crosslinking steps
When you visit an ideal clinic in London, your doctor will explain all these procedures in detail before signing you up for the corneal crosslinking treatment.
What can I expect after the procedure?
Advantages and risks of collagen corneal crosslinking
Collagen corneal crosslinking is an effective and safe method of repairing collagen fibers without resorting to corneal transplantation. It proves effective for extremely thin corneas and can be performed on teenagers as well. It provides quicker vision improvement than other procedures and, most importantly, halts the further progression of keratoconus in the process, lessening
The side effects
A significant risk associated with the procedure is that of herpes reactivation. For this reason, candidates with a history of herpes are exempted from the treatment. The risk of sterile infiltrates resulting in inflammation is the main risk associated with the treatment. Apart from that, endothelial thinning and corneal haze, albeit temporary, are other complications associated with the corneal crosslinking treatment procedure. But these can be reversed with the help of a capable surgeon and by the use of regular medications post-surgery. That’s why it is imperative to look for an ideal surgeon in London before moving ahead with the rest of the process. In this regard, AI Vision, London, will be your ideal bet. We have a team of world-class optometric surgeons to take care of your treatment in London with ease.
Frequent asked questions (FAQs):
Collagen corneal crosslinking is a procedure mainly used to treat keratoconus, a condition causing a conical bulging of the cornea. Apart from keratoconus, it is used in general for strengthening corneas. Any condition causing corneal thinning and ectasia like bullous keratopathy, chemical burns, and even corneal infections can be easily treated.
In collagen corneal crosslinking, the surgeon uses riboflavin eyedrops on the eyes. After this, he treats the eyes with a special type of UV radiation. The UVA reacts with the riboflavin to form a reactive oxygen species that react with the collagen fibrils in the corneal stroma. The main aim of the corneal crosslinking is to repair the thin cornea and prevent further thinning of it.
Post instillation of riboflavin drops takes 30 minutes for the drops to soak in, after which the eyes are treated with the machine emitting UV radiation. The entire corneal crosslinking procedure takes place under local anesthesia in about 30-60 minutes. Multiple sessions may be required for the effective healing collagen fibers.
Yes, you will be awake during the procedure but under the effect of sedatives. Topical anesthetics will be installed before the surgery not to feel any pain or discomfort during the procedure.