Corneal Cross-Linking (CXL) Treatment in Chicago
WHAT IS KERATOCONUS
Keratoconus is a degenerative condition of the cornea which causes it to bulge outward taking on more of a cone shape verses a dome shape. As the cornea bulges, the collagen tissue which gives the cornea its shape begins to stretch and break. This results in a thinner, more unstable, cornea. Approved in 2016, the Avedro KXL system, combining an eye drop containing riboflavin (vitamin b2) with a UV light, helps to strengthen the collagen tissue in the cornea and prevents further stretching and weakening.
KERATOCONUS SIGNS AND SYMPTOMS
Symptoms can vary so it is recommended that you consult with an eye specialist who can assess and diagnosis the condition. Some signs of Keratoconus may include;
- Constant and regularly changing refractive errors with increasing astigmatism
- Blurry vision that may not be correctable with glasses or contact lenses
- Increased light sensitivity
- Difficultly driving at night
- Halos around lights and ghosting (especially at night)
- Eye strain
- Headaches and general eye pain
- Eye irritation, excessive eye rubbing
WHAT IS CORNEAL CROSS-LINKING PROCEDURE
Keratoconus and corneal ectasia are degenerative conditions in which the cornea’s collagen weakens and begins to stretch outward and thin. Corneal weakening and thinning are caused by the collagen bonds breaking or stretching in the cornea. The weakened collagen alters the corneal shape and effects how the light enters the eye. This can result in blurred vision.
Cross-Linking for Keratoconus is a procedure which uses a combination of riboflavin eye drops (i.e. a type of vitamin B) and ultraviolet (UV) light to help strengthen the cornea from further weakening. The goal of crosslinking is to strengthen the corneal collagen bonds. A Crosslinking treatment does not reverse the blurred or distorted vision that has already occurred but attempts to prevent the vision from getting worse.
Prior to the Crosslinking treatment, a patient will need a complete eye exam to determine the severity of their keratoconus or corneal ectasia. Based on the exam, the doctor will determine if a crosslinking procedure is a viable treatment option. Crosslinking is a newly approved FDA procedure.
CORNEAL CROSS-LINKING (CXL) SURGERY
At the Kraff Eye Institute, we perform the FDA approved, “Epi-Off” technique. What that means is that we use a surgical instrument to gently brush off the surface cells of your cornea, known as the epithelium. We feel that by removing the top layer of cells, the riboflavin eye drop penetrates deeper into the cornea allowing for better results. The epithelium that is removed regenerates back on its own. This may take a few days to occur so the patient should plan on some initial downtime to recover. The Avedro KXL system is the only FDA approved treatment for crosslinking in the United States.
On the day of your treatment you should plan on being in the office for about 2 hours. A patient will be given a mild oral sedative to help them relax during the treatment. We will use several sets of numbing drops to ensure a comfortable, pain-free, procedure for the patient. Once numb, Dr. Kraff will use an instrument to gently remove the top layer (epithelium) of your cornea. Once removed, we will start to administer a medicated eye drop called Photrexa; which contains an active ingredient called riboflavin. Once the cornea is saturated with the Photrexa, we will then use the KXL system, which utilizes a UV light. The UV treatment is 30 minutes and during this time we will continue to administer the Photrexa. The UV light, combined with the Photrexa, starts the crosslinking reaction in your cornea and strengthens the collagen tissue. Following the procedure, Dr. Kraff will place a soft bandage contact lens on your eye. You will wear this lens for several days following the treatment as your eye heals. You will be on a restricted schedule following the procedure, so you will need to discuss what your limitations are with the doctor when scheduling. After the cornea has healed, Dr. Kraff will remove the bandage lens.
CORNEAL CROSS LINKING RECOVERY
Once the treatment is complete, Dr. Kraff will place a clear, soft bandage, contact lens on the eye. A patient will wear this lens for the first couple of days following the procedure. During this time, a patient is advised to avoid most of their normal day to day tasks, i.e. no work, no driving, no staring at a computer, no reading, etc. A patient should plan accordingly so that they have the necessary downtime to heal. It is normal to experience some discomfort during the first 1 to 2 days following the treatment. A patient will be given oral pain medication to help minimize the discomfort. A patient will also be using prescription eye drops for the first several days, to months, after the treatment. Once the epithelium is healed, which only takes a couple of days, Dr. Kraff will remove the bandage contact lens. Most patients can resume their normal activities later that day, or the following day.
Insurance coverage varies and depends on the patient’s specific plan. Our billing department can assist with determining what your out of pocket cost for the procedure will be and if you qualify for financial assistance through the ARCH program.
The FDA has approved a crosslinking procedure for patients who are 14 years or older. The goal of a crosslinking procedure is to stop the progression of Keratoconus. With that said, the earlier the condition is diagnosed and monitored, the better.
FAQ about corneal cross linking
Can I go blind from Keratoconus?
- If left untreated, Keratoconus can result in permanent vision loss.
Is a Crosslinking procedure painful?
- A patient will be given several sets of numbing drops to create a pain-free experience.
Can I go back to work following being treated?
- A patient will need to plan on taking some time off to recover and heal. Dr. Kraff will discuss the recovery period and advise you on how much time you’ll need to take off of work or school.
How long will the procedure take?
- A patient should plan on being in our office for around a hour and a half on the day of surgery.
Can I have LASIK after a Crosslinking treatment?
- LASER eye surgery consists of using a laser to remove tissue from the cornea. With that being said, LASER eye surgery is not recommended after Crosslinking.
Dr. Colman Kraff
About your Doctor
Dr. Colman Kraff first developed a passion for ophthalmology when he witnessed his father perform a cornea transplant at the age of 13. Since then, Dr. Kraff has devoted his life to helping his patients see the best that life has to offer.
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