What is the safety profile regarding the use of ultra-violet light and of riboflavin in the eye?
The ultraviolet light exposure during a cross-linking procedure is comparable to, or even less than, the exposure of the eye to the ultraviolet light in skylight for a full day outdoors in summer. The riboflavin drops are simply vitamin B2, commonly used in foods such as your breakfast cereal.
How many people have undergone a cross-linking procedure?
Thousands of people have had their corneas cross-linked in Europe during the past 13 years. Due to the universal acceptance of the benefits of cross-linking among ophthalmologists, and recent advances in technology, the annual number of cross-linking procedures is expected to increase substantially. Commonwealth Eye Care Associates has been treating cornea ectasia patients with cornea cross linking since September 14, 2012. WEO was the first site in Virginia to offer cross linking to its patients.
What are the possible complications and side effects of cross-linking?
Pain in the first 1-2 days, sensitivity to light for several days, haze within the cornea that may cause blurring for up to a few weeks. There are other, more severe and less common, possible complications and side effects Dr. Iuorno can discuss with you. For a more comprehensive list of possible side effects, please see the details of the informed consent.
Am I asleep for the treatment?
No. You will be awake for the treatment. You’ll be given relaxing medication and anesthetic drops to numb any sensation or discomfort.
Does it hurt?
There is some discomfort during immediate recovery but not during the treatment. Immediately following treatment, a bandage contact lens is placed on the surface of the eye to protect the newly treated area. After the numbing drops wear off, there is some discomfort, often described as a gritty, burning sensation managed with Tylenol & artificial tears. If pain is severe, oral narcotic medications will be used.
How long does the treatment take?
Actual treatment for each eye takes about 20 - 30 minutes but you will be at the office for 1 to 2 hours to allow sufficient time for preparation and recovery before you return to the comfort of your own home.
What results can I expect?
Individual results vary but most people’s vision returns to pre-operative status and return to driving and work within 1 week. Some degree of cloudiness/ blurriness is expected to last up to 1 month. Although this procedure is specifically intended to halt the progression of thinning, your astigmatism may reduce as recovery progresses, usually over a 6 & 12 month period after treatment.
Can cross-linking be redone if needed?
Yes, but during the past 13 years a one-time treatment has been shown generally to be enough to treat progression.
Can both eyes be cross-linked at the same time?
Technically yes, but the short term blurring due to the current FDA procedure protocols, this is not possible.
Will this be covered under insurance in the future?
We believe this is the next phase in cornea care for patients with keratoconus or post-refractive ectasia. Insurance coverage based on individual insurance medical policies and qualifications.
Will I need to be out of my contact lenses for this process?
Yes. Contact lenses can warp the cornea. It is the goal of cross linking to strengthen the cornea in its natural state. In order to allow for contact lens induced warpage to reduce, patients must come out of CL before the screening visit. Many times, this will require additional visits to achieve stability. Once treated, patients will not be allowed back into contact lenses for 1 month.
