What is Keratoconus?
Keratoconus, often referred to as “KC,” is a non-inflammatory eye condition in which the typically round dome-shaped cornea progressively thins and weakens, causing the development of a cone-like bulge and optical irregularity of the cornea. This causes “static” in your vision and can result in significant visual impairment.
Normal Cornea vs. Keratoconic Cornea
In its earliest stages, keratoconus causes slight blurring and distortion of vision and increased sensitivity to glare and light. These symptoms usually appear in the late teens or early 20s. Keratoconus affects both genders although it is unclear whether significant differences exist between males and females. The disease is also found in all ethnic groups with some studies showing higher incidence rates among Asian populations, in particular.
Keratoconus may progress for 10-20 years and then slow in its progression. Each eye may be affected differently. As keratoconus progresses, the cornea bulges more, and vision may become more distorted. In a small number of cases, the cornea will swell and cause a sudden and significant decrease in vision. The swelling occurs when the strain of the cornea's protruding cone-like shape causes a tiny crack to develop. The swelling may last for weeks or months as the crack heals and is gradually replaced by scar tissue. If this sudden swelling does occur, your doctor can prescribe eye drops for temporary relief.
Other symptoms include:
- Slight blurring of vision
- Distortion of vision
- Increased sensitivity to light
- Excessively rubbing your eyes
- Hard to see at night
- Frequent changes, or unable to change your vision with glasses
- Frequent headaches
The cornea is responsible for focusing most of the light that comes into the eye. Therefore, abnormalities of the cornea, such as keratoconus, can have a major impact on how an individual sees the world, making simple tasks such as driving a car or reading a book very difficult.
Keratoconus Treatment Options
Current treatment options for keratoconus include eyeglasses or soft contact lenses, rigid gas permeable contact lenses, scleral contact lenses, intracorneal ring segment implants, corneal cross-linking or corneal transplant surgery.
What Is iLink™ Corneal Cross-Linking?
iLink™corneal cross-linking is a minimally invasive outpatient procedure that combines the use of ultraviolet light and specially formulated eye drops to stiffen and strengthen corneas that have been weakened by disease or refractive surgery. Cross-linking is considered the standard of care around the world for progressive keratoconus and corneal ectasia following refractive surgery. Corneal Cross-Linking creates new corneal collagen cross-links, resulting in a shortening and thickening of the collagen fibrils which leads to the stiffening of the cornea.
iLink™ is the only FDA-approved corneal cross-linking procedure for the treatment of progressive keratoconus, which means it has been proven safe and effective in rigorous clinical studies. This outpatient procedure uses specially formulated prescription eye drops called Photrexa® (riboflavin 5’-phosphate ophthalmic solution) and Photrexa® Viscous (riboflavin 5’- phosphate in 20% dextran ophthalmic solution), combined with ultraviolet (UV) light from the KXL® System, to slow or halt the progression of disease.
Is Cross-Linking Right for Me
Patients who have been diagnosed with progressive keratoconus or corneal ectasia following refractive surgery should ask their doctor about iLink™ corneal cross-linking.
Our practice is proud to offer patients the first and only FDA-approved therapeutic solution for the treatment of progressive keratoconus. Now, patients who once had little to no therapeutic option to treat keratoconus have the opportunity to slow or halt the progression of this sight-threatening disease.
The Keratoconus Procedure
iLink™ corneal cross-linking requires removal of the epithelium. Dr. Lindahl will apply topical anesthesia to numb the eye prior to the removal of the epithelium. This process helps prepare your eye so that the drug can penetrate the tissue of the cornea to have an effective iLink™ procedure.You are typically awake during the treatment and you may be given relaxing medication and numbing anesthetic drops.
What to Expect During the Procedure
After numbing drops are applied, the epithelium (the thin layer on the surface of the cornea) is gently removed
• Photrexa® Viscous eye drops will be applied to the cornea for at least 30 minutes
• Depending on the thickness of your cornea, Photrexa® drops may also be required
• The cornea is then exposed to UV light for 30 minutes while additional Photrexa® Viscous drops are applied
The actual procedure takes about an hour, but you will be at the office for approximately 2 hours to allow sufficient time for preparation and recovery before you return to the comfort of your own home.
What to Expect After the Procedure
There is some discomfort during immediate recovery but usually 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 acetaminophen and artificial tears. If pain is severe, oral narcotic medications may be prescribed.
You should not rub your eyes for the first 5 days after the procedure. You may notice a sensitivity to light and an uncomfortable sensation in the treated eye. Sunglasses may help with light sensitivity. If you experience severe pain in the eye or any sudden decrease in vision, you should contact us immediately. If your bandage contact lens from the day of treatment falls out or becomes dislodged. you should not replace it. Contact us immediately.
Side effects of iLink™ corneal cross-linking
The most common ocular adverse reactions in any corneal cross-linked eye were haze (corneal opacity), inflammation (punctate keratitis), fine white lines (corneal striae), disruption of surface cells (corneal epithelium defect), eye pain, reduced sharpness of vision (visual acuity) and blurred vision.
The safety and effectiveness of corneal cross-linking has not been established in pregnant women, women who are breastfeeding, patients who are younger than 14 years of age and patients 65 years of age or older.
iLink™ Corneal Cross-Linking FAQs
Q: What is keratoconus?
A: Keratoconus, often referred to as “KC,” is a non-inflammatory eye condition in which the typically round, dome-shaped cornea (the clear part of your eye) progressively thins and weakens, causing a cone-like bulge and optical irregularity of the cornea. Keratoconus can result in significant visual loss and may lead to corneal transplant if left untreated.
Q: What is iLink™ corneal cross-linking?
A: iLink™ is the only FDA-approved corneal cross-linking procedure for the treatment of progressive keratoconus, which means it has been proven safe and effective in rigorous clinical studies. This minimally invasive outpatient procedure uses specially formulated prescription eye drops called Photrexa® (riboflavin 5’-phosphate ophthalmic solution) and Photrexa® Viscous (riboflavin 5’-phosphate in 20% dextran ophthalmic solution), combined with ultraviolet (UV) light from the KXL® System, to slow or halt the progression of the disease.
Q: Will I need to be out of my contact lenses for this process?
A: Yes. Typically, doctors ask their patients to stop wearing contact lenses prior to surgery for several weeks. Once treated, patients may not be allowed back into contact lenses for up to 1 month.
Q: How much does an iLink™ procedure cost?
A: The iLink™ procedure is widely covered by commercial insurance policies in the United States. Please contact your insurance carrier or your healthcare provider to understand any out-of-pocket costs you may be responsible for.