What is Keratoconus?

Keratoconus (kehr-uh-toh-koh-nus) is a condition in which the normally round, dome-shaped cornea thins and becomes distorted and irregular. A cone-like bulge develops, resulting in significant visual distortion. With keratoconus, the apex of the cone is usually displaced outwards and downwards and in the line of sight, creating an irregular astigmatism.

Our fellowship-trained cornea-specialists and LASIK surgeons Dr. Reza Mozayeni and Dr. Trey Nunnery here in Charlotte, frequently encountered this common disease during consultations. In the past, these patients with keratoconus typically needed a corneal transplant, but there is an exciting, new, non-invasive treatment on the horizon.

Corneal Cross-Linking: A Keratoconus Treatment Option

Corneal cross-linking (CXL), which has been performed in Europe since 1997, has been FDA approved for several years in the United States. However, because it took so many years to acquire FDA approval, the methodology used in this FDA-approved version is considered outdated. This method of CXL is called Epi-OFF, where the top skin layer of the cornea is removed as part of the CXL procedure for keratoconus treatment.

The alternative corneal cross-linking method is called Epi-ON or trans-epithelial CXL. With this method, the outer skin layer of the cornea is not removed, which provides many advantages. These advantages include much faster recovery, the ability to have both eyes treated on the same day, less chance of infection and scarring, and much less discomfort during the recovery.

Epi-ON CXL is a relatively non-invasive and low-risk procedure designed to strengthen the corneal tissue of a person’s eye, particularly when keratoconus exists. The goal of CXL for keratoconus treatment is to prevent the corneal tissue from progressively weakening, thereby prolonging or avoiding a riskier and invasive corneal transplant

How is corneal cross-linking performed?

Corneal cross-linking is performed by applying liquid Riboflavin to the eye to saturate the cornea followed by a specific amount and duration of ultraviolet light. This combination causes strong bonds to form between corneal fibers, providing strength and stability to the tissue. In some cases, in addition to treating keratoconus, it also reduces the amount of astigmatism for vision to improve. This creates more options for vision correction, such as standard soft or toric contact lenses, glasses, and even laser vision correction.

Epi ON corneal cross-linking now available for specific situations!

As cornea specialists, Dr. Mozayeni and Dr. Nunnery have been carefully following the development of corneal cross-linking for many years and firmly believe it is in the best interest of patients to undergo the Epi-ON version of this procedure. FDA approval for the Epi-OFF version occurred in the middle of 2016, and is available at some facilities but has since become outdated.

Will I be a candidate for corneal cross-linking with keratoconus?

If you have been told that you have keratoconus, now is the time to begin considering Epi-ON corneal cross-linking as a way to halt the disease process and prolong or prevent the need for a corneal transplant.

FDA Phase 3 clinical trial of Epi-ON corneal cross-linking

At Providence Eye & Laser Specialists, we now are one of approximately 24 sites in the United States participating in an FDA Phase 3 clinical trial of Epi-ON corneal cross-linking and currently enrolling potential candidates that qualify. There will be no charge to study participants who qualify and enroll in this study.

Please call our office (704) 540-9595 and ask to speak to our CXL study coordinator for more information and to explore if you might be a candidate for this clinical trial.

Learn More About the FDA Phase 3 Clinical Trial of Epi-ON Crosslinking

Call (704) 540-9595 or fill out this short form to be contacted by our study coordinator.

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