If you suffer from Keratoconus, chances are that you’ve heard something about a treatment to slow or halt the progression of Keratoconus called Corneal Cross-Linking. This procedure might sound complicated, but it is actually a quite safe and effective method of slowing or halting the progression of Keratoconus. To explain the advanced technology involved, we’ve put together this helpful guide to treating progressive Keratoconus with Corneal Cross-Linking. See how this state-of-the-art treatment can protect your eyes and preserve your vision!

In this article, you will learn…

What Is Keratoconus?

Keratoconus is a relatively rare ocular condition that causes the cornea to thin and warp, bulging outward. This makes it impossible for the eye to properly and consistently focus light into the pupil, resulting in blurry vision, headaches, and light sensitivity.

Most recent research has shown that Keratoconus is sometimes caused by hereditary factors and aggravated by secondary medical conditions, such as allergies or irritation. For some patients, their eyes lack the structural fibrils that stabilize the outer part of the eye, which causes the cornea to bulge.

What is Corneal Cross-Linking?

Corneal Cross-Linking is a treatment that can help to strengthen the cornea with the goal of slowing or halting this degeneration of your cornea, preventing further damage to the eye, and preserving vision. There are two basic types of Corneal Cross-Linking:

  • Epithelium-Off (epi-off): During these procedures, the thin outer layer of the cornea (known as the epithelium) is carefully removed, allowing liquid riboflavin to effortlessly penetrate the corneal tissue. We use the iLink® Cross-Linking Procedure, the only FDA-approved epi-off procedure currently available.
  • Epithelium-On (epi-on): In this process (also called transepithelial Corneal Cross-Linking) the epithelium is retained, which means that it is more difficult for the riboflavin to penetrate the cornea. Epi-on procedures are not FDA-approved at this time, and are considered experimental.

No matter the specific process, Corneal Cross-Linking aims to strengthen the weak fibers that bind together the collagen fibers of the cornea. It can also be combined with vision management treatments, such as speciality contact lenses, to help you see better and more comfortably.

Doctor performing the iLink® Cross-Linking Procedure on a patient with progressive KC
Treating Keratoconus with corneal cross-linking

How successful is Corneal Cross-Linking?

Corneal Cross-Linking is very effective in stopping the progression of Keratoconus – the success rate for slowing or halting the progression of Keratoconus is more than 95% for the FDA-approved iLink procedure.

How long does it take to recover from Corneal Cross-Linking?

The treated eye is usually painful for less than a day, although levels of discomfort vary from patient to patient. Recovery time is about a week although most patients may find that it may be slightly longer. After a day, patients can resume most of their regular activities except those that might risk injury to the face (such as sports).

What should I expect when treating Keratoconus with Corneal Cross-Linking?

Before you schedule an appointment for treating progressive Keratoconus with Corneal Cross-Linking, your Optometrist will need to conduct a routine eye exam to assess your general health, measure the thickness of your corneas, and determine your eligibility for this cutting-edge treatment. A short assessment known as corneal topography will examine the condition of the surface of your eyes.

Most Corneal Cross-Linking procedures take about an hour, plus about a half hour of pre-operative preparation and post-operative review.

During this minimally invasive procedure, your eye doctor will apply liquid riboflavin drops to the surface of the eye. This is immediately followed by a carefully monitored ultraviolet light treatment. This process works to stiffen the cornea by increasing the number of molecular bonds, or cross-links, in the collagen.

After the procedure, your optometrist will prescribe a topical antibiotic and anti-inflammatory drops to speed your recovery. They may also ask you to wear a protective contact lens to protect your eye. Although you may experience some irritation and itchiness in the next few weeks, your eye should fully heal within one week.

Patient undergoing the iLink® Cross-Linking Procedure exposing their eye to UV light to activate the riboflavin solution.

Does Medical Insurance Cover Corneal Cross-Linking?

The medical necessity of FDA-approved iLink Corneal Cross-Linking has become widely recognized. As a result, over 95% of commercial insurance providers cover the iLink® Cross-Linking Procedure. At the moment, there are no other Corneal Cross-Linking procedures that are generally covered by medical insurance.

How Safe is the iLink® Cross-Linking Procedure?

In general, treating Keratoconus with Corneal Cross-Linking is safe. However, all medical procedures carry some risk. According to Glaukos, the developer of the procedure and its components,

The most common ocular adverse reactions in any corneal cross-linked eye were haze (corneal opacity), inflammation (punctate keratitis), fine white lines (corneal striae), disruption of surface cells (corneal epithelium defect), eye pain, reduced sharpness of vision (visual acuity) and blurred vision.

What is Photrexa?

Photrexa®️ (riboflavin 5’-phosphate ophthalmic solution) and Photrexa® Viscous (riboflavin 5’-phosphate in 20% dextran ophthalmic solution) are the prescription eyedrops used during the iLink cross-linking procedure. You can view the official Photrexa prescribing information here.

Contact The California Keratoconus Center Today

Now that you have read our guide to treating progressive Keratoconus with Corneal Cross-Linking, it’s time to schedule your eye exam. Dr. Leonard, the founder and Clinical Director of the California Keratoconus Center (CKC)  has earned a reputation as one of the country’s most experienced and knowledgeable Keratoconus specialists. All of the Keratoconus Doctors at the CKC staff can perform a thorough eye exam and evaluate your eligibility for treating Keratoconus with Corneal Cross-Linking. If you want to take advantage of this exciting new treatment, please call us today at 818-891-6711!