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Corneal Collagen Cross-Linking for Keratoconus

Corneal collagen cross-linking (CXL) is currently the only treatment that may slow down the progression of keratoconus. This is a minimally invasive procedure to strengthen corneal tissue and stabilize the cornea’s shape.

If you have been diagnosed with keratoconus, or if you are concerned that your condition might be deteriorating, contact Dr. Nicholas Belill at Belill Eye Care, PLC to evaluate whether CXL is the best option for you.

What Is Corneal Collagen Cross-Linking?

Corneal collagen cross-linking is a surgical procedure performed by a corneal specialist or ophthalmologist to stabilize the shape and firmness of the cornea. By applying riboflavin (vitamin B2) eye drops and ultraviolet light, the surgical treatment promotes the building of new collagen fiber links within the cornea. In many cases, it helps prevent the need for a corneal transplant.

Collagen plays a vital role in creating and maintaining the smooth round shape of the eye’s surface. The tightness of the woven collagen fibers determines the strength of the corneal tissue. A weak cornea is prone to deformation, causing keratoconus to progress.

CXL is also effective in treating corneal ulcers in cases where topical antibiotics did not produce results. Several other corneal infections have also successfully been treated with CXL.

Your Optometrist Prepares You for CXL

A few steps need to be taken before you undergo corneal collagen cross-linking. Dr. Nicholas Belill can assess whether you are a candidate and get you ready for the surgical procedure.

1) We’ll Evaluate If You Need CXL

At Belill Eye Care, PLC, we will inquire into your patient history to determine whether any previous eye surgeries might prevent you from undergoing CXL. We will also examine several other factors, such as keratoconus progression and corneal thickness. In case you have dry eye, this needs to be treated appropriately before scheduling the CXL procedure.

2) Connecting You With The Right Surgeon

Following your eye exam and the evaluation of your suitability for CXL, we will connect you with an ophthalmologist to schedule the actual procedure. We at Belill Eye Care, PLC work with the finest corneal specialists in the area because we want you to be in good hands.

3) Pre-Op Exam With Your Optometrist

Just before the surgery, you will have a short pre-op examination at Belill Eye Care, PLC. Lens wearers are required to remove their contact lenses a few days prior to this examination so that measurements can be entirely accurate.

We will gather measurements about visual acuity, refraction, the shape of the corneal surface, and intraocular pressure. The data generated in this examination will be used for comparison in every future examination, and provide background for follow-up should the keratoconus continue to progress after the surgical intervention.

The CXL Procedure

seniors smiling 2 640The ophthalmologist will first apply riboflavin eye drops (vitamin B2) to the surface of the eye. This substance is conducive to photo-enhancing; in other words, it improves light absorption. Next, the practitioner will expose the eye to a specific ultraviolet light to activate the development of new collagen cross-linking. This will cause the collagen fiber to thicken across the entire cornea and reinforce it.

There are two types of corneal cross-linking procedures:

  • Epithelium-on cross-linking or transepithelial cross-linking. In this procedure, the doctor applies the eye drops onto the outer layer of the cornea, called the epithelium.
  • Epithelium-off cross-linking. To allow the riboflavin to penetrate more easily into the lower layers of the cornea, the doctor removes its outer layer before applying the drops. This surgical intervention has a slightly higher risk, as it could cause the disruption of surface cells in the epithelium.

We Provide Post-Op Care

The success of the one-hour surgical treatment depends as much on the quality of postoperative care as it does on the procedure itself. Careful management of eye health is essential for rapid rehabilitation of visual clarity and to reduce the risk of complications.

Follow-up care provided at Belill Eye Care, PLC includes three main objectives, of which the speedy healing of the corneal surface is primary. Generally, patients are prescribed temporary soft contact lenses to protect the eye surface during the healing process. The lenses also serve the purpose of minimizing potential pain.

To prevent infections, Dr. Nicholas Belill will provide topical antibiotics and other medications that may be needed to protect the cornea and ensure a safe and fast recovery.

Who Can Undergo Corneal Collagen Cross-Linking?

The surgical treatment is recommended for patients who have recently been diagnosed with keratoconus and patients with a rapidly worsening condition. The sooner the treatment is applied, the better the chances of strengthening the cornea or even improving its shape.

Because CXL does not restore lost vision, early treatment is critical to prevent visual acuity from declining. This can also increase the chances of wearing traditional contact lenses later on.

Patients with stable keratoconus, a thin cornea, or a scarred cornea may not benefit from CXL and can potentially delay or avoid the procedure altogether.

Contact Dr. Nicholas Belill at Belill Eye Care, PLC for additional information or to schedule an eye exam.

Our practice serves patients from Clio, Flint, Flushing, and Mt. Morris, Michigan and surrounding communities.

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Keratoconus Patients Can Avoid Corneal Surgery With Scleral Lenses

All surgical procedures come with risks, which is why they are usually prescribed as a last resort after trying other interventions.

This is equally true for keratoconus—an eye disease that causes the cornea to become misshapen. Although corneal surgery is generally safe, it can at times lead to complications like infection, permanent corneal scarring, transplant rejection and corneal haze.

Research has shown that patients with severe keratoconus who wear scleral lenses significantly reduce their need for corneal surgery.

Below, we’ll cover the ins and outs of keratoconus and explain how scleral lenses can safely and effectively manage the condition.

What is Keratoconus?

Keratoconus affects approximately 0.05-0.25% of the global population. It is a progressive eye condition that causes the cornea to thin and become cone-like in shape, affecting how light enters the eye. It usually affects both eyes but may lead to differing vision in each eye if a single eye is affected.

Symptoms of keratoconus include:

  • Blurred or distorted vision
  • Increasing sensitivity to light or glare
  • Red or swollen eyes
  • Increasing nearsightedness or astigmatism
  • Frequent changes in lens prescription
  • The inability to wear standard soft contact lenses

The exact cause of keratoconus isn’t well understood, but risk factors for developing the disease include genetics, oxidative damage, eye rubbing and certain health conditions like allergies, asthma, Down syndrome and retinitis pigmentosa.

In the early stages of keratoconus, soft contact lenses or glasses may be enough to successfully correct vision. But over time, the cornea becomes so misshapen that these methods are no longer effective. Surgical procedures performed on keratoconus patients include corneal cross-linking, refractive surgery and keratoplasty (corneal transplant).

What are Scleral Lenses?

Scleral lenses have a larger diameter than standard soft lenses and cover most of the sclera (the white part of the eye).

Because they don’t put any pressure on the cornea or sclera, they are very comfortable to wear—even for patients with corneal disease. The lens prevents the bulging cornea from rubbing against the eyelid and protects it from environmental irritants.

The space between the scleral lens and the eye is filled with a nourishing liquid that allows oxygen to reach the eye while keeping it hydrated. It also acts as an artificial cornea that helps focus light into the eye, providing sharp and clear eyesight.

Scleral lenses are tailor-made for each eye to ensure the patient achieves the best vision possible.

How Scleral Lenses Can Reduce the Need for Corneal Surgery

In a study involving 51 eyes with severe keratoconus, 40 of them were able to avoid surgery by wearing scleral lenses. While all patients in the study were candidates for corneal transplants, scleral lenses cut the need for keratoplasty by more than half over a 5-year span.

In fact, the study found that managing stage 4 keratoconus with scleral lenses was more effective and safer than keratoplasty.

The features of scleral lenses are ideal for keratoconus patients in several ways. Because they don’t touch the cornea, the rate of scar formation slows down and the cornea isn’t irritated. Moreover, scleral lenses are very stable and fit securely to the eye’s surface. This prevents them from moving around with each blink (as standard lenses do), making them much more gentle on the patient’s sensitive eyes.

If your or a loved one has been diagnosed with keratoconus or is experiencing any of the associated symptoms, we can help. A consultation with Dr. Nicholas Belill will help determine the best-suited treatment for your eyes.

Schedule an appointment by calling one of our friendly staff members at Belill Eye Care, PLC today.

Our practice serves patients from Clio, Flint, Flushing, and Mt. Morris, Michigan and surrounding communities.
Request A Scleral Lens Appointment Today
Can Scleral Lenses Help You? Find Out! 810-775-5100
Learn More About Scleral Lenses for Keratoconus
Scleral Lens Blog Thumbnail.jpg

Scleral Lens Blog

Scleral Lenses for Keratoconus Thumbnail.jpg

Scleral Lenses for Keratoconus

Specialty FAQ Thumbnail.jpg

Scleral Lenses: FAQ

What are Scleral Lenses Thumbnail 1.jpg

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