Keratoconus is a progressive eye condition that affects the structure of the cornea, causing it to thin and bulge into a cone shape. This distortion of the cornea leads to blurred vision, sensitivity to light, and, in severe cases, vision loss. For many years, patients with keratoconus faced limited treatment options, often relying on contact lenses or corneal transplants in advanced stages. However, recent advancements in ophthalmology, such as Corneal Cross Linking, have revolutionised the management of keratoconus, offering patients a less invasive and highly effective treatment option.
What is Corneal Cross-Linking?
Corneal Cross-Linking is a minimally invasive procedure designed to strengthen and stabilise the cornea in patients with keratoconus. The procedure involves applying riboflavin (vitamin B2) eye drops to the cornea, followed by exposure to ultraviolet (UV) light. This process helps to form new bonds between the collagen fibres in the cornea, making it stronger and more resistant to the progression of keratoconus.
Unlike other treatments, Corneal Cross Linking does not aim to reshape the cornea or improve vision directly. Instead, its primary goal is to halt the progression of keratoconus, preserving the patient’s existing vision. For many patients, this procedure can delay or prevent the need for more invasive treatments, such as corneal transplant surgery.
Who is a Candidate for Corneal Cross-Linking?
Corneal Cross Linking is most effective for patients in the early stages of keratoconus, when the condition is still progressing. In many cases, early intervention can significantly slow or even stop the disease from worsening. Patients with mild to moderate keratoconus, who still have good visual acuity, are often considered ideal candidates for the procedure.
Additionally, Brisbane Eye Clinics may recommend Corneal Cross Linking for patients whose keratoconus has worsened despite wearing contact lenses or glasses. This treatment is also beneficial for individuals who are not eligible for more invasive surgical options or who wish to delay the need for corneal transplants.
It is important to note that Corneal Cross Linking is not a cure for keratoconus, but rather a stabilising treatment. Patients who undergo the procedure will still need to wear corrective lenses, but the procedure may reduce the need for future surgeries.
The Procedure
The Corneal Cross Linking procedure is typically performed in an outpatient setting and usually takes about 60 to 90 minutes. The steps involved are as follows:
- Preparation: The eye is numbed using local anaesthetic drops, and the top layer of the cornea (epithelium) is gently removed to allow the riboflavin drops to penetrate the cornea effectively.
- Riboflavin Application: Riboflavin drops are applied to the cornea for about 30 minutes, allowing them to saturate the tissue.
- UV Light Exposure: Once the cornea is sufficiently saturated with riboflavin, a controlled amount of UV light is shone onto the eye for around 10 to 30 minutes. The UV light, in combination with the riboflavin, stimulates the formation of new collagen bonds within the cornea.
- Recovery: After the procedure, a soft contact lens is placed on the eye to protect it while the epithelium heals. Most patients experience mild discomfort, such as redness, sensitivity to light, and a gritty feeling in the eye, which typically subsides after a few days.
Recovery from Corneal Cross Linking can take several weeks, with full visual stabilisation occurring over the next few months. Patients are usually able to resume normal activities within a week of the procedure, but they are advised to avoid strenuous activities and protect their eyes from bright light during the healing process.
Effectiveness and Benefits
Corneal Cross Linking has been shown to be highly effective in slowing or stopping the progression of keratoconus in the majority of patients. Studies have demonstrated that the procedure stabilises the cornea in around 90% of cases, reducing the need for more invasive treatments, such as corneal transplants.
For patients in Brisbane Eye Clinics, Corneal Cross Linking offers several benefits:
- Minimally Invasive: The procedure is relatively simple and does not require extensive surgery, making it a less invasive option compared to corneal transplants.
- Preserves Vision: By stabilising the cornea, Corneal Cross Linking helps to preserve the patient’s existing vision and prevent further deterioration.
- Long-Term Stability: The effects of Corneal Cross Linking are long-lasting, with many patients experiencing stable vision for years after the procedure.
- Prevents More Serious Interventions: By halting the progression of keratoconus, Corneal Cross Linking can delay or prevent the need for corneal transplants, which are more complex and carry a higher risk of complications.
Risks and Considerations
While Corneal Cross Linking is generally safe, like any medical procedure, it carries some risks. Potential side effects include temporary discomfort, dry eyes, and a slight risk of infection. In rare cases, patients may experience visual disturbances such as haze or blurred vision during the healing process. However, these side effects are usually mild and resolve over time.
It is important for patients to discuss their individual case with an experienced Eye Surgeon in Brisbane before deciding to undergo the procedure. Proper evaluation and careful consideration of the patient’s condition will help ensure the best possible outcome.
Conclusion
For patients with keratoconus, Corneal Cross Linking represents a significant advancement in the management of the condition. By strengthening and stabilising the cornea, this minimally invasive procedure can slow or halt the progression of keratoconus, preserving vision and reducing the need for more invasive treatments.
At Southside Eye Centre, our experienced eye surgeons offer Corneal Cross Linking as part of our comprehensive range of services. With a commitment to using the latest technology and evidence-based treatments, we aim to provide our patients with the best possible care for their vision needs.
