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Keratoconus and Collagen Cross-Linking

Keratoconus DiagramThe cornea is the clear front window of the eye. It is normally round and smooth. Keratoconus is a disease in which the cornea thins and begins to bulge into a cone-like shape. Keratoconus literally means cone-shaped cornea. The abnormal shape can cause serious distortion of vision.

Keratoconus usually affects both eyes but can be asymmetric. It often appears in the late teens or early twenties and is a progressive condition. As the cornea becomes steeper and more irregular in shape, nearsightedness and irregular astigmatism develop.

Keratoconus ComparisonThe cause of keratoconus is still unclear. Factors that might be associated with this condition include a genetic predisposition, ultraviolet rays, contact lens wear, and excessive eye rubbing. The treatment of keratoconus depends on the severity of the condition. In mild cases, eyeglasses or contact lenses can be used. As the disease progresses and the cornea becomes more irregular, hard or custom-made contact lenses are required to reshape the cornea.  


In patients with severe keratoconus that can no longer obtain functional vision with contact lenses, surgical procedures may be needed to restore vision such as Intracorneal Ring Segments (ICRS), which are small plastic segments that can be surgically placed in the cornea to help improve the curvature of the cornea. Corneal transplants may be indicated for patients in whom other therapies no longer provide acceptable vision. It is estimated that only 20% of people with keratoconus will require corneal transplant surgery. Even after a transplant, most patients will likely need glasses or contact lenses for clear vision.  


Topography changes in Keratoconus


In April of 2016, the FDA approved the Avedro KXL System for corneal collagen cross-linking here in the United States. This system is the first and only FDA approved cross-linking device to patients with progressive keratoconus or post-refractive ectasia, and we are proud to offer this treatment.  

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