Baltimore Washington Eye Center, Maryland

Saturday, December 10, 2011

Corneal Crosslinking for Keratoconus

For decades, people suffering from advanced keratoconus had few options other than corneal transplant surgery, otherwise known as Penetrating Keratoplasty (PKP). Beyond the risks posed by the surgery itself, PKP patients face many months of healing and always carry the risk of transplant rejection. Researchers have long sought a means by which keratoconus and similar diseases might be stopped or even reversed; thereby reducing the need for invasive procedures like PKP

Since the late 1990's, and especially over the past several years, there has been an increasing body of evidence suggesting that applying riboflavin (Vitamin B2) to the human cornea followed by an application of ultraviolet (UV) light can stabilize diseases like keratoconus.  During this process, the UV light interacts with riboflavin to create more bonds between collagen molecules in the cornea. The increased bonds, or cross-linking, creates an increase in corneal strength.

In the US, there is an FDA phase III study underway. Hopefully, the study results will make corneal cross-linking (CXL) available to the general public before too long. While there are certain risks associated with CXL, the hope is that by treating keratoconus in its early stages, we can halt its progression, improve patients' vision, and reduce, if not eliminate, the need for PKP surgery. Eyewiki video of CXL