Corneal Cross-linking – What You Need to Know
Corneal cross-linking is a treatment for keratoconus and post-LASIK ectasia in which a special laser and riboflavin eye drops are used to strengthen the cornea, stabilize vision, and prevent further corneal bulging.
Since 2012, Parker Cornea has partnered with Avedro in the study of corneal cross-linking for keratoconus and post-LASIK ectasia. In April 2016, Avedro received final FDA approval to be the sole provider of corneal cross-linking materials in the US. We are excited that this wonderful advance is now available.
What is corneal cross-linking?
In the US, corneal cross-linking is a method of strengthening the cornea and making it more resistant to structural change by using Avedro’s riboflavin eye drops and laser.
Who might benefit from corneal cross-linking?
Someone whose cornea demonstrates structural deterioration–that is, someone with progressing keratoconus or with ectasia after refractive surgery.
When should corneal cross-linking be done?
If a cornea is physically changing, cross-linking should be done as soon as possible because there is no good way to restore normal shape to a deformed cornea.
So corneal cross-linking cures keratoconus and ectasia after refractive surgery?
No. Corneal cross-linking stabilizes corneas and retards further progression of keratoconus and ectasia. A modest improvement in corneal shape is often noted in keratoconic corneas and some continuing improvement even seven years after treatment of post-LASIK ectasia has been reported.
Does corneal cross-linking limit my future therapeutic choices such as contact lens wear, Intacs implantation, or Bowman layer or corneal transplantation?
Are there any risks to corneal cross-linking?
Yes. Problems after cross-linking are uncommon but include infection and the development of corneal haze.
Is corneal cross-linking painful?
Cross-linking, itself, does not hurt. The eye is numbed with drops. A lid speculum is used to keep the eye open for the procedure. The top layer of the cornea (corneal epithelium) is gently removed to allow penetration of riboflavin eye drops into the cornea. While the epithelium is healing for several days after the procedure, the eye is generally uncomfortable. Oral pain medication or a bandage contact lens can be helpful.
How often do I need to be seen after corneal cross-linking?
Usually, at least three times. Patients return to our office 1-3 days after treatment. Additional post-op visits are typically scheduled 2-3 weeks and 2-3 months after treatment. We suggest that you return to our office at least until your corneal epithelium is healed. (Typically occurring within 3 days of treatment.) Visits after the epithelium has healed can be scheduled with us or with your local eye care provider.
Who should perform my cross-linking treatment?
We hope you will chose Parker Cornea for your treatment. We participated in Avedro’s US FDA clinical trials and have extensive experience performing cross-linking on a wide variety of eyes. We are also currently the only doctors preforming corneal cross-linking in Alabama.
Is corneal cross-linking covered by my insurance?
Although corneal cross-linking is a well studied medical procedure that has been the standard of care throughout the rest of the world since 2006, the FDA only recently (April, 2016) approved corneal cross-linking for use in the US. As a result, corneal cross-linking is not yet covered by US insurers. Our charge for the procedure is per eye and includes treatment, riboflavin drops, and post-op follow up care in our office for up to 3 months. Frequently, both eyes do not require treatment. If both eyes are treated, we suggest that you wait at least one week between eyes.