Keratoconus Prevention and Treatment
Interview with Elena Alexandri Malayan, Head of the Department of Advanced Diagnostics and Laser Treatment at the S.V. Malayan Eye Center
Topic: Effectiveness of Cross-linking Technique
Cross-linking is an advanced method for treating keratoconus, developed in Germany and Switzerland, widely used in leading European clinics, and has been performed at the S.V. Malayan Eye Center for about three years.
By applying specially designed, dosed ultraviolet laser radiation to the stromal layer of the cornea, it is possible to slow down—and sometimes even halt—the progression of keratoconus, avoiding the need for corneal transplantation. The cross-linking procedure is completely safe, performed on an outpatient basis, and lasts 40–80 minutes.
In the first stage, special drops containing a photosensitive component are applied to saturate the stromal layer of the cornea.
The second stage involves laser exposure on the cornea saturated with the solution.
As a result, the cornea undergoes “cementing,” strengthening its structure, which slows thinning and central protrusion.
Thus, the progression of keratoconus is stopped, and the eye’s refraction remains stable.
Swiss Professor Theo Seiler, one of the method’s founders, said: “If my son suffered from keratoconus, I would have him undergo this treatment tomorrow.”
FAQ
- Slowing the progression of keratoconus, stabilizing refraction, and preventing the need for corneal transplantation. Typically, the treatment is performed once and provides stable results for 8–10 years (the period of corneal stromal structure renewal), after which the procedure can be repeated if necessary.
- Corneal thickness at the thinnest point less than 400 µm.
Patients with herpetic corneal infections, inflammatory corneal diseases (keratitis), or tear film deficiency (dry eye syndrome) are not candidates for cross-linking.
– The procedure is divided into 8 consecutive stages and lasts approximately 80 minutes:
Stage: premedication of the eye with pupil-constricting drops.
Stage: local topical anesthesia with drops.
- Stage: placement of a lid speculum and removal of the corneal epithelium.
- Stage: instillation of Lidocaine drops.
- Stage: instillation of riboflavin phosphate drops for 10–15 minutes.
- Stage: instillation of riboflavin solution and initiation of ultraviolet irradiation, monitored in real time via the laser monitor.
- Stage: continued instillation of drops every 2–3 minutes throughout the laser exposure.
- Stage: thorough rinsing of the corneal surface, instillation of anti-inflammatory drops, and placement of a therapeutic contact lens, which is removed after 5 days.