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Crosslinking without Epithelium Removal?

Keratoconus (also known as Pellucid) is a progressive non-inflammatory disorder that causes a characteristic thinning and cone-like steepening of the cornea. This steepening results in distortion of vision, increased sensitivity to glare and light and an associated reduction in visual acuity. These symptoms usually appear in the late teens and early twenties. Keratoconus may progress for 10-20 years and then can slow or even stabilize. Each eye can be affected differently. This can result in a dramatic decrease in the ability to see clearly even with corrective lenses. (Note:  as keratoconus and pellucid are the same disease process, any reference to "keratoconus" on this site also applies to "pellucid" as well.)

New research shows Keratoconus is much more common than in past.  Years ago Keratoconus occurred in 1 in 2000 people, now it is 1 in 500, a 400% increase. No one is sure why there was been an increase in Keratoconus, but this is concerning.

Eyeglasses or soft contact lenses may be used to correct the mild nearsightedness and astigmatism in the early stages of keratoconus. As the disorder progresses and the cornea continues to thin and change shape, rigid gas permeable (RGP) contact lenses can be prescribed. The contact lenses must be carefully fitted, and frequent checkups and lens changes may be needed to achieve and maintain adequate vision.

It is not uncommon to develop intolerance to RGP contacts characterized by foreign body sensations, light sensitivity, irritation, and discomfort. Corneal scarring occurs in more advanced cases and further reduces vision. Until now a corneal transplant (penetrating keratoplasty) was the only option available to advanced keratoconus patients.

Patients come to us from all over the United States and often from other countries.  Please click below to listen to patients share in their own words how the process was for them and the ways their lives have been changed.

Keratoconus is the thinning and bulging of the cornea. Treatments include Intacs^®, Holcomb C3-R^®, cornea collagen cross linking, and if keratoconus progresses to a serious level, cornea transplantation. Dr Brian Boxer Wachler is a specialist in keratoconus evaluation and treatment.