a sight-saver
CXL treatment
Shortly before the 2010 Vancouver Winter Olympics , United States bobsled driver Steven Holcomb was going blind . Diagnosed with keratoconus , a degenerative eye condition that thins the cornea , causing it to bulge like a cone and distort vision , Holcomb underwent a new treatment that saved his sight and allowed him to keep racing . His four-man team won an Olympic gold medal at the Vancouver Olympics .
The olympian ’ s sight-saving eye treatment included a special contact lens implant . His therapy also involved bathing his cornea with riboflavin to strengthen corneal tissue and stop keratoconus from progressing .
Hundreds of people in Canada now undergo a similar procedure for this condition every year . Known as Corneal Collagen Cross-Linking ( CXL ), it can help stabilize vision and prevent it from worsening , says the Canadian Keratoconus Foundation . The foundation estimates more than 30,000 Canadians are afflicted with keratoconus .
The condition usually starts in the teenage years , but it can begin in people as old as 30 . Early symptoms include blurry vision and frequent changes in eye glass prescriptions . People with keratoconus may have difficulty driving at night . They may see halos and glare , especially when it ’ s dark , and they may be more light sensitive . In the disease ’ s early stages , eye glasses or contact lenses can help correct vision , but CXL is the only treatment that can stop keratoconus , says the foundation . There is no minimum age at which a patient can undergo CXL . “ Studies have shown earlier treatment of keratoconus halts progression , results in better outcomes and an increased chance of preserving vision . It avoids the need for future corneal transplant surgery and halts deterioration in quality of life ,” says Dr . Avi Wallerstein , co-founder of LASIK MD , whose surgeons performed have performed 800 CXL procedures , including 360 in the last year . “ If keratoconus is diagnosed as a teenager or young adult , it is generally in the patient ’ s best interest to undergo the procedure as soon as possible before it continues to progress .”
The CXL treatment involves gently brushing off the surface skin of the cornea , soaking it with riboflavin ( vitamin B2 ) and exposing it to ultraviolet light for five minutes . When combined with the riboflavin , the ultraviolet light stimulates a reaction that increases the collagen bonds in the cornea that have been weakened by the disease .
“ The treatment is effective in over 95 per cent of patients ,” Dr . Wallerstein says . “ It improves uncorrected visual acuity ( UCVA ) in the majority of patients and it improves best corrected visual acuity ( BCVA ) in over half of those treated .”
When CXL is combined with topography-guided PRK laser treatment to flatten the corneal cone , patients benefit from a regularized cornea and reduced astigmatism .
“ The improved corneal shape facilitates visual rehabilitation with glasses and contact lenses ,” Dr . Wallerstein says .
Parents who have kerotoconus are encouraged to have their children ’ s eyes checked by age 10 because this condition tends to run in families .
26 OPTICAL PRISM | JULY / AUGUST 2013