What is Cross-linking?

The cornea is the clear front surface of the eye. It covers the colored part of the eye and provides a significant amount of our focusing ability.  The cornea is made of a material that is very common throughout the body called collagen. The collagen provides structural stability to the cornea. The collagen in the cornea is like little fibers running through the substance of the cornea. For us to maintain stable vision, the collagen must remain stable to maintain a constant shape to the cornea.  Even if someone needs glasses to see clearly, the prescription is based on a specific corneal shape and corneal stability. If the shape of the cornea is continually changing, it will cause a continual change in the glasses prescription, making it difficult to maintain clear vision.

Keratoconus is a genetic disease of the collagen in the cornea.  It causes the collagen to continually change shape resulting in progressive irregularities in the cornea. This causes progressive changes in vision and glasses. Eventually, the corneal irregularities can become advanced enough that glasses don’t work well.  Contact lenses may then be an option.  However, if the process continues, contact lenses eventually may no longer work, and a major corneal transplant operation might be the only remaining option for vision improvement.

A procedure has been developed that has a very good success rate at arresting this progressive collagen problem.  The procedure is called Corneal Collagen Cross-linking. It works by creating cross-bridges between the collagen fibrils to stabilize their shape. During the treatment, specially prepared vitamin A drops are applied to the cornea to saturate it.  Then a specific wavelength of ultraviolet light is applied to the eye to activate the vitamin A and create the cross-links.

The treatment itself is not painful; however, the eye may ache and burn slightly in the first four days after the procedure. It is an outpatient office procedure and is covered by most insurance. There are specific criteria that must be met to be eligible for the treatment. These can be determined by eye history review and an in-office evaluation.

This treatment is a fantastic development and can prevent patients with keratoconus from experiencing a long, frustrating road of failed corrections and possibly avoiding major surgery.

This technology is available at Eye Specialists of Mid-Florida. Call 863-294-3504 ext. 1548 to speak with our Cross-Linking Coordinator, Karina, to find out if you are a candidate for this quality-of-life treatment.

Bio: David Loewy, M.D., is a board-certified ophthalmologist who performs Corneal Collagen Cross-linking, LASIK, and Laser Surgeries. He sees patients at the Haines City, Sebring, and Winter Haven locations for Eye Specialists of Mid-Florida.

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