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Thread: One of a Kind Eye Treatment

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    One of a Kind Eye Treatment

    ATLANTA, Ga. (Ivanhoe Newswire) -- It's an eye disease that forces people into a dark, blurry world. Every day, people with keratoconus watch their vision slip away. Until now, a cornea transplant was the only option, but a few tiny drops may save their sight.

    "I literally can see nothing unless it's six to eight inches away from my face," Marsha Watts told Ivanhoe.

    Where others see details, Watts, a schoolteacher sees only a blur. Every year, keratoconus takes away a little more of her sight.

    "Os look like Cs," she described. "Cs look like Gs. I can't see things at a distance. Night vision is very bad so I don't drive at night."

    A normal cornea is round, but in keratoconus the cornea stretches into a cone shape, blurring vision. A clinical trial is testing a new treatment called CXL. Drops of riboflavin, or vitamin B2, are applied to the cornea in phases. An ultraviolet light activates the drops.

    "There's a reaction between the ultraviolet light and the riboflavin, which joins or links the collagen molecules in the cornea and in doing so, makes it stiffer," Doyle Stulting, M.D., Ph.D., an ophthalmologist at Emory Eye Center in Atlanta, Ga., told Ivanhoe.

    That stiffness prevents the cornea from stretching, keeping its round shape. CXL is approved in Europe. Dr. Stulting was the first to perform the procedure in the United States.

    "It's not very often in your career where you have an opportunity to treat a disease that had no treatment available," he said.

    It can take months for vision to improve, but Watts saw results quickly.

    "I had tears in my eyes," she recalled. "I was so excited that at one week, already I was seeing improvement."

    She hopes that's a sign of things to come.

    CXL is also being tested on a similar eye condition called ecstasia, which happens when people with weak corneas get Lasik surgery to correct their vision. International trials show CXL slows the progression of both conditions, which cause 15 percent of cornea transplants. Ten sites across the nation are recruiting participants for clinical trials of the new treatment.


    For Your Ready Reference:

    Corneal Collagen Cross-Linking

    Corneal collagen cross linking with Riboflavin (Vitamin B2), or CXL, is a new procedure to strengthen a weakened cornea. The commonest cause of a weakened cornea is called Keratoconus— “kerato” means cornea and “conus” meaning conical i.e. a conical cornea.

    The cause of keratoconus is unknown but there is strong evidence that this disease has a genetic basis. Other conditions resulting from a weakened cornea are Pellucid Marginal Degeneration and more recently Corneal Ectasia secondary to LASIK or PRK(photorefractive keratectomy).

    CXL was devised by IROC co-founder Prof. Theo Seiler together with Prof. Eberhard Spoerl from the University of Dresden, Germany. CXL minimises the need for invasive corneal transplantation for people suffering from weakened corneas like Keratoconus and Corneal Ectasia.

    It works by increasing the stiffness and rigidity of the cornea, thus stabilising the ectasia. In other words, the more cross-linking there is, the stronger the cornea becomes.

    It is a known fact that in Singapore, and the world over, the number of available donor corneas is significantly lower than the corresponding demand. Corneal transplantation has also been associated with a number of complications, like rejection with resultant clouding and failure of the corneal transplant. CXL is a much less invasive procedure that can delay the need, and if done early can obviate, the need for a corneal transplant.

    How does CXL work?

    Your cornea is mostly made up of collagen fibres that are arranged in bundles, and the strength and rigidity of the cornea is determined by how strongly these fibres are linked together. Thus, when CXL is done on the cornea, the collagen fibres become linked together more strongly hence the term cross-linking.

    This effect is more pronounced nearer the corneal surface. The biomechanical strength of the cornea itself is improved by a factor of 4. Over the course of a lifetime, your cornea becomes progressively stiffer due to natural cross-linking between the fibres.

    CXL makes use of Riboflavin(Vitamin B2) and UV light, for instance through photo-polymerisation. Riboflavin is a naturally occurring compound which strongly absorbs Ultra Violet(UV) light. When Riboflavin is applied to the cornea and exposed to UV light at the same time, this enhances the effect of the cross-linking procedure as well as absorbs the UV light to protect the inner layers of the cornea and intraocular structures from the potentially damaging effects of the light rays.

    for More details:

    Jerry Tan Eye Surgery


    Dr. H. D. Riley's Anterior Segment Slides

    FDA permits Swiss attempt to study benefits of CXL

    In a first research of its kind, the Swiss-based Peschke Meditrade GmbH has initiated a investigation to study the benefits of corneal collagen cross-linking (CXL) in subjects with progressive keratoconus and corneal ectasia after prior refractive surgery. Presently keratoconus is treated through eyeglasses, hard contact lenses, and a newer treatment, INTACS plastic rings inserted into the mid layer of the cornea to flatten it, changing the shape and location of the cone. In 15-20% of the cases, cornea transplant surgery is necessary.

    please visit for More Details on: Keratoconus

    Keratoconus - Clinical News & Knowledge


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