Keratoconus

Cross-Linking: A Breakthrough Treatment for Keratoconus

Since 2016, when the United States Food and Drug Administration approved the iLink® cross-linking technology, more patients are asking us, “What is cross-linking?” It sounds like a type of fence or a sewing technique – but for patients at Eye Specialty Group, it is so much more significant than that.

Cross-linking is an outpatient, minimally invasive surgery that is used to treat a weakened or warped cornea, a condition called keratoconus. Disease, age, inflammation and injury can all contribute to the breakdown of collagen in the cornea, which plays a vital role in holding it together. This weakening of tissue allows the cornea to bulge out, which causes blurriness and other visual disturbances. “Cross-linking” is designed to stop the progression of keratoconus by strengthening the bonds between collagen fibers of the eye, thus stabilizing the cornea.

Now that you know what cross-linking is, let’s review what it treats and how it works.

What does cross-linking treat?

Cross-linking is commonly used to treat keratoconus (KC). This condition is when the cornea thins and weakens, causing a bulge that distorts vision. Cross-linking slows the progression of KC by creating new collagen connections to reinforce the cornea. Think of these new bonds as support beams for the eye.

How does cross-linking work?

Cross-linking uses ultraviolet light and specially formulated eye drops together to increase the number of molecular bonds, or cross-links, in the collagen of the cornea. This stiffens the cornea and slows – or even stops – the progression of keratoconus. The cross-linking procedure is quick and straightforward:

• The surgeon numbs the eye(s) with special anesthetic eye drops, so the patient is comfortable during the procedure.
  
• The ophthalmologist removes the outer layer of the cornea, called the epithelium, which allows cross-linking medication to penetrate deeper into the cornea.
  
• Specially formulated riboflavin eye drops are applied to the cornea and allowed to soak in for about 30 minutes.
  
• Next, ultraviolet light is focused on the cornea for an additional 30 minutes to activate the riboflavin. This process helps in the formation of new molecular bonds, or cross-links, between the collagen fibers in the cornea.
  
• The surgeon protects the eye(s) with a special bandage contact lens that assists in healing. This bandage is removed after about a week.

During the first week of healing, it’s important to take it easy in a clean environment and NOT rub your eyes, get water in your eyes or use makeup near your eyes.

Does cross-linking hurt?

There is no pain during cross-linking, thanks to numbing drops that are applied before treatment starts. Once the anesthetic drops wear off, patients may experience mild burning or a gritty sensation, which can usually be managed with acetaminophen and artificial tears.

Is cross-linking FDA approved?

iLink® is the first corneal cross-linking treatment to receive FDA approval. This is significant because insurance doesn’t typically cover products and procedures that lack FDA approval or that have not been proven safe and effective in clinical trials. Thus, iLink is the first cross-linking procedure covered by insurance.

What are the advantages of iLink® corneal cross-linking?

Eye doctors and patients love iLink corneal cross-linking for a variety of reasons, including clinically proven safety and effectiveness in protecting the eye from progressive keratoconus damage.

• iLink immediately improves vision after healing. Eyeglass wearers typically need a lower prescription after treatment, and contact lenses are more comfortable after healing.
  
• iLink has been shown to slow down or even stop the progression of keratoconus for up to 10 years in patients of all ages.
  
• The Photrexa® and Photrexa Viscous riboflavin (vitamin B) formulations and the KXL® UV cross-linking device have been rigorously tested for safety and efficacy. The U.S. Food and Drug Administration has approved both the drops and the device – the only cross-linking treatment to achieve FDA approval.
  
• Thanks to FDA approval, iLink is widely covered by insurance in the U.S.
  
• Cross-linking has an impressive 95 percent success rate.

If you suffer from keratoconus, talk to a doctor with Eye Specialty Group about iLink® cross-linking treatment to preserve your vision.

Call (901) 685-2200 or tap here to request an appointment with one of our Memphis area eye doctors.