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Corneal Crosslinking (CXL)

Corneal Collagen Crosslinking (CXL)

Slade & Baker Vision was the first site in Texas to do corneal cross linking as part of a clinical trial. We offer screening evaluations, at no charge, for patients with ectasia and or KERATOCONUS to find out their options. 

Please click on this link to view the press release on the previous cross-linking trial.

Purpose: Corneal Crosslinking (CXL) is a treatment for Keratoconus patients and for Post-LASIK Ectasia patients that experience corneal thinning after Refractive Surgery. The US trial showed that this one-time treatment will strengthen the cornea so that the progression of Keratoconus or Corneal Ectasia is slowed or stopped.

Background: Corneal Collagen Crosslinking (CXL) has been proven in studies to strengthen a weakened corneal structure, as in keratoconus. After extensive studies, CXL received approval from the US Food and Drug Administration (FDA).

Keratoconus/Effects: The cornea is the clear membrane that covers the colored part of the eye and pupil. The cornea is the “window” of the eye and is the most powerful lens in the eye as well. Keratoconus is a corneal disease that causes structural changes within the cornea causing the cornea to thin and bulge outward into a steeper, irregular, more conical shape than its normal gradual curve. Keratoconus can cause substantial visual loss of vision, image distortion, streaking of lights, sensitivity to light, and multiple images, etc. Keratoconus affects about one person in a thousand, and yet the exact cause of it is uncertain. It has been associated with genetic factors and linked to detrimental abnormal enzyme activity in the cornea; however, the findings are still inconclusive. Many patients with keratoconus may be treated with corrective lenses, glasses, contact lenses, intrastromal corneal ring segments, and as a last resort, corneal transplantation. In order to stabilize the cornea, keep the keratoconus from progressing and even avoid having to have a corneal transplant, many patients now have chosen to travel from around the world to have corneal collagen crosslinking, also known as "CXL."

Goal: Crosslinking (CXL) has been shown to increase the number of corneal crosslinks within the cornea. These links are like the natural anchors in the cornea and are responsible for preventing the cornea from bulging outwards and becoming steep and irregular. The goals of crosslinking are to stop the progression of keratoconus, decrease the severity of the corneal bulging, and allow the patient to continue or resume contact lens wear. By decreasing the severity of the corneal bulging, doctors are better able to fit the patient for contact lenses.

Procedure: The crosslinking treatment is an outpatient procedure performed in the surgical laser suite using numbing eye drops. During the treatment, the surgeon uses an ultraviolet-A illumination device (UVA light treatment) with vitamin B2 eye drops to treat the cornea (front of the eye). In the clinical trials, the Epithelial-Off procedure was used. WIth that procedure, the outer layer of the cornea, the epithelium, is prepared for the procedure. If a patient is having the Epithelial On procedure which is performed at Slade & Baker Vision in Houston, this step is skipped. Next, vitamin B2 (riboflavin) eye drops are instilled in the eye and the patient is asked to look at an ultraviolet light while lying comfortably in a reclining chair. The patient’s eyes are numbed through the use of anesthetic drops, and the patient lays down comfortably with their choice of music playing while they wait. 

After treatment: Post operatively, most patients start to notice the effects in their vision 4-8 weeks after the traditional (epithelial-off) procedure and the final effects usually take 3-6 months. Every patient is different, visual results may differ. Many patients are able to proceed with laser vision correction after healing from the cross-linking procedure.

 

Read Angela F.'s review of Slade & Baker Vision Center on Yelp

 

 

Please visit the National Keratoconus Foundation's website to learn more.

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