How Holcomb C3-R® Was Developed
Brian S. Boxer Wachler, MD
The first 1998 publication
of crosslinking was with epithelium removal and
it showed ability to stabilize the disease, but it reported
pain in recovery and corneal swelling side effects (future
studies would show many more side effects from epithelium-removal
crosslinking such as corneal ulcers, cornea haze, very slow
recovery, partial loss of vision, etc). Nonetheless after
this publication, there was one peculiar thing: no
one was performing crosslinking. The publication
was out there, but went largely unnoticed by the ophthalmology
community and medical societies. It was the equivalent of
a "silent shot in the dark." Not one doctor around
the world seemed to notice this publication in 1998, except
one doctor: myself.
I was fascinated when I read this study
as I was already was pioneering the use of Intacs® for
Keratoconus as an alternative to invasive corneal transplants
that carry significant risks. After my own research into crosslinking,
I quickly realized that scaping off the epithelium will cause
a lot of pain during the recovery and other potential problems.
I thought, "there MUST be a better way!"
worked to develop a way to perform crosslinking WITHOUT needing
to do the invasive step of scraping off the cornea's epithelium
top layer (aka transepithelial crosslinking). After
many, many nights working on this after hours, I finally discovered
a method to obtain successful results. Was it possible
to have a completely non-invasive, transepithelial (epithelium-on)
procedure that stops Keratoconus in its tracks without the
risks that epithelium removal crosslinking inherently carries?
The answer was a resounding "YES!"
After this discovery, I could hardly sleep that night in
remember very vividly our first patient. He is a very famous
movie producer in Hollywood (due to patient privacy, I cannot
mention his name, but you would know his movies and the A-list
stars of those movies), He unfortunately had Keratoconus develop
after LASIK. I explained the nature of this new procedure
that I invented. (I hadn't given it a name then). He was open
to it and trusted me. The results were incredible:
we stopped his Keratoconus from progressing and he was very
happy. And best of all: he was back at the work the
very next day after the procedure, no discomfort, no time
off work, no change in his life. It was amazing, just a one
I discussed with my wife Selina my excitement.
On a plane flight with Selina shortly afterwards, I explained
the nature of the procedure and that it needed to have a simple
name. It would be hard for people to say: riboflavin in the
cornea for collagen crosslinking. A lot of great ideas have
been written on the back of a napkin. I suppose we can add
the naming of this procedure to that list. Years ago I learned
a process to help with creativity. You draw the words of interest
in a circle and then keep looking at the words. Usually with
time the solution will hit you. On the back of a United Airlines
napkin I did this with Selina at my side.
the name of the procedure jumped out like a jack-in-box from
the circle of words: C3-R®. There were three words with
letter "C" (corneal collagen crosslinking) and one
word with "R" (riboflavin). Eventually I obtained
a United States Trademark for C3-R®. Since the C3-R®
procedure is distinctly different from invasive epithelium
removal crosslinking and other "home grown" epithelium-on
crosslinking that some other doctors are trying to do now,
I wanted to be sure we protected our established crosslinking
C3-R® brand that uses a proprietary Crosslinking Solution
(that contains riboflavin and other compounds). By doing this,
the proprietary C3-R® procedure could never be confused
with less desirable or unproven crosslinking techniques. C3-R®
now has over 10 years behind it. Since 2003, people
know and trust C3-R® since it has stood the test of time
and has a Gold medal behind it.
trademark C3-R®? It's like with Coke®
that is a protected brand owned by The Coca-Cola Company.
When you buy a Coke®, you know exactly what
you're getting. You know it won't taste different from what
you expect. You know Coke® is made from the
secret formula locked in a vault somewhere deep in The Coca-Cola
Company headquarters in Atlanta, Georgia. You know if you
buy a Coke, it's not an unauthentic knockoff from another
company – they can’t call their cola "Coke"
because The Coca-Cola Company owns the trademark for Coke®.
These are all the same reasons that C3-R® is
trademarked (and yes, our secret formula for our Crosslinking
Solution is also locked in a vault). People know
with C3-R® they are getting the "real
2007, our Keratoconus patient Steven Holcomb, the top bobsled
driver for the United States team, regained 20/20 vision from
C3-R® and Visian ICL and came back from vision-related
retirement. He won Gold in 2010 at Vancouver, the first Gold
for the U.S. in 62 years. On April 9, 2010 when Steven and
I were on Dr. Phil's The Doctors television show, I announced
the name modification of "C3-R®" to "Holcomb
C3-R®" in honor of Steven Holcomb. This marked the
first time in history that a treatment for a disease was named
after a Gold Medal athlete who made the treatment world-famous.
Because of the massive media exposure about Steven's accomplishment
and his comeback from Keratoconus, people around the world
now know there are options besides invasive and painful cornea
This website is designed to provide general information
about vision, vision care and vision correction. It is
not intended to provide medical advice. If you suspect
that you have a vision problem or a condition that requires
attention, consult an eyecare professional for advice
on the treatment of your own specific condition and for
your own particular needs.
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