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HEALTH TIPS

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KERATOCONUS & COLLAGEN CROSS-LINKING!

Keratoconus is a progressive eye disease that changes the shape of the cornea.
The cornea is the eye s protective layer that covers the optical apparatus of
the eye. It allows vision by permitting the light to enter the eye. The cornea
is round in shape. But sometimes, it gets thin and bulges out to form a cone
shape. This change in shape deflects the light entering the eye. It leads to
blurred or distorted vision or both. It might also cause nearsightedness,
astigmatism, light sensitivity, and glare. This condition is called Keratoconus.

It can affect either the eyes or just one eye. Usually, it begins at a young
age, in teens or early twenties. It is believed that Keratoconus is caused due
to an imbalance in the enzymes of the cornea, causing it to deteriorate and get
weak.

Keratoconus is associated with excessive rubbing of the eye, chronic irritation,
poorly fitted contact lenses, and overexposure to ultraviolet rays. The disease,
when not too severe, can be managed (not treated) using regular soft lenses and
eyeglasses. However, as the disease progresses, these devices remain inadequate
in correcting the vision. In such cases, a surgical therapy called Collagen
Cross-Linking is employed to correct the vision.

Collagen Cross-Linking:

Corneal collagen cross-linking is a surgical therapy which uses a
photosensitizer and ultraviolet light to form stronger chemical bonds in the
cornea. This treatment halts irregular and progressive changes (ectasia) in the
shape of the cornea. Ectatic changes are marked by thinning of the cornea and an
increase in the curvature. It causes myopia and astigmatism.

Collagen cross-linking allows collagen fibrils to chemically bond strongly with
the adjacent fibrils. It is a relatively non-invasive procedure that stabilizes
the cornea. This significantly reduces the need for corneal transplants for
patients suffering from Keratoconus.

The Procedure:

Performed under topical anesthesia, the patient lies down in the sterile
operating room. The patient's epithelium of the cornea is removed gently. Then,
Riboflavin solution is applied at an interval of five minutes for the first half
an hour. It is followed by exposing the patient s cornea to ultraviolet light
for nearly half an hour. Thus, the procedure lasts for almost an hour and is
painless. The eye is patched at the end of the treatment.

Types of Collagen Cross-Linking:

There are two types of Collagen Cross-Linking: epithelium - on and epithelium -
off.

Epithelium - on or transepithelial crosslinking is the procedure in which the
outer layer of the cornea (epithelium) is left intact. It hence requires more
time for riboflavin penetration but causes less discomfort, less risk of
infection, and faster recovery.

Epithelium - off requires the removal of the epithelium to allow entry and
penetration of riboflavin into the cornea.

Who can Undergo Collagen Cross-Linking?

It must be established that the patient is suffering from progressive
Keratoconus.

The thickness of the cornea must be at least 400 microns.

The patient should not be nursing or pregnant.

Post the Procedure:

Work can be resumed within three to four days after the procedure.

Water should be avoided from entering the eye for almost a week.

Contact lenses can be used for six weeks after the treatment.

The surgeon assesses healing daily for the first two to three days until the
epithelium heals completely.

Eye drops prescribed by an ophthalmologist or surgeon have to be used for almost
four months.

Following up with the doctor should be scheduled for six weeks, three months,
six months, and one year after the procedure.

Also, if there is any pain or irritation or distorted vision, the same should
immediately be reported to the doctor.

Take Away:

Although the method is quite popular and effective, it is advisable to always
consult a doctor before going for this method.
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