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Corneal Crosslinking

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 progressive condition can cause vision distortion and can result in significant vision impairment.

8 Potential Signs & Symptoms

  1. Frequent Changes in Refraction or Increasing Cylinder
  2. Family History of Keratoconus
  3. Reduced Best Corrected Visual Acuity
  4. Excessive Eye Rubbing
  5. Frequent Headaches
  6. Difficulty Seeing at Night
  7. Halos and Ghosting
  8. Increased Light Sensitivity
Chart Illustrating a Normal Eye vs One With Keratoconus


Closeup of Corneal Crosslinking

Cross-linking is a minimally invasive, FDA approved, outpatient procedure that combines the use of prescription eye drops, Photrexa® Viscous (riboflavin5’-phosphate in 20% dextran ophthalmic solution), Photrexa® (riboflavin 5’-phosphate ophthalmic solution), and ultra-violet A (UVA) light from the KXL® system for the treatment of progressive keratoconus.

Patients who have been diagnosed with progressive keratoconus should ask their doctor whether they may be an appropriate candidate for corneal cross-linking.

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 Tylenol and artificial tears. Optional pain medications may be offered. Oral narcotic medications may be used.

  • 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 min;
  • 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.
  • You should not rub your eyes for the first five days after the procedure.
  • You may notice a sensitivity to light and have a foreign body sensation. You may also experience discomfort in the treated eye and sunglasses may help with light sensitivity.
  • If you experience severe pain in the eye or any sudden decrease in vision, you should contact your physician immediately.
  • If your bandage contact lens from the day of treatment falls out or becomes dislodged, you should not replace it and contact your physician immediately.

In clinical trials, progressive keratoconus patients had an average Kmax2 reduction of up to 1.4 in Study 1 and 1.7 diopters in Study 2 (which is flattening) at 12-months post-procedure, while the control group had an average increase of up to 0.6 diopters at
12-months (which is steepening). Individual results may vary.

Please contact our practice for specific pricing information.

For information on the FDA approved corneal cross-linking procedure for the treatment of keratoconus and corneal ectasia following refractive surgery, visit

Corneal Transplant

The cornea is the clear covering on the front of the eye which bends, or refracts, light rays that focus on the retina in the back of the eye. A certain shape or curvature is required in order for light to focus exactly on the retina, rather than in front of it or behind it.

An improperly curved cornea may be corrected surgically or non-invasively to reduce or eliminate the need for eyeglasses or contact lenses. A thorough eye examination and consultation are necessary before a treatment decision can be made.

Corneal transplantation, or keratoplasty, is recommended when the cornea’s curvature is too steep or flat to be treated with other methods, or when extensive damage has occurred due to disease, infection or injury. Common problems that require transplantation are:

Transplantation involves replacing the damaged cornea with a healthy one from a donor (usually through an eye bank). Keratoplasty is a low-risk procedure – it is the most common type of transplant surgery and has the highest success rate.

During the procedure, a circular incision is made in the cornea. A disc of tissue is removed and replaced with healthy tissue; these discs may be thin (lamellar keratoplasty) or as deep as the entire cornea (penetrating keratoplasty), depending on the eye problem. Local or general anesthesia may be used. The entire procedure takes only 30-90 minutes.

PROKERA® Biologic Corneal Bandage


The PROKERA® biologic corneal bandage is designed to help heal and protect the inflamed surface of the eye. Approved by the FDA, the PROKERA corneal bandage is an anti-inflammatory used to reduce pain, minimize scarring and promote healing. The PROKERA corneal bandage consists of a segment of amniotic membrane tissue fitted between two clear, flexible rings. The amniotic membrane, which is found within the human placenta, is donated by women who have been medically screened and have provided consent after a cesarean-section childbirth. The amniotic membrane is cryopreserved and saved in a tissue bank regulated by the FDA.

The PROKERA Treatment

The PROKERA treatment option may be used in patients with the following conditions:

The PROKERA biologic corneal bandage protects the surface of the eye from external irritants, relieving pain and promoting healing. The PROKERA bandage is placed on the eye by a physician and patients should not remove it unless otherwise instructed. It is similar to a contact lens in shape, but slightly thicker, so some patients experience discomfort during a short adjustment period. Special instructions that must be followed after the insertion of the PROKERA corneal bandage will be provided.

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