Surgical Options for Keratoconus: Corneal Crosslinking Combined with ICL

May 15, 2024


If you have been diagnosed with keratoconus, you probably have many questions. This condition causes progressive changes to your cornea, the clear structure at the front of your eye, leading to deteriorating vision and possible scarring if left untreated. In the past, keratoconus often progressed to the need for a corneal transplant. Today, corneal cross-linking, can halt keratoconus disease progression, and often eliminate the need for a cornea transplant.  After corneal cross-linking, patients still need visual correction for astigmatism and myopia in the form of glasses, contacts, or EVO ICL implantation.  

What is Keratoconus?

Keratoconus is a condition affecting your corneas. If you have keratoconus, your corneas are thinner and more cone-shaped. As a result, you may experience blurry vision and the need for glasses or contact lenses to see clearly. This condition most often begins in the late teens or young adulthood and may progress for a decade or more. Fortunately, there are excellent treatment options to halt disease progression and clear vision. 

Keratoconus Costa Mesa & Orange County

Surgical Options for Keratoconus: Corneal Crosslinking Combined with PRK or ICL

If you come to One EyeCare for keratoconus treatment, we will use the most advanced technology to both stabilize your condition and help you see better.  One of the most effective ways to treat keratoconus is performing corneal cross-linking to strengthen the cornea and stop disease progression.  Depending on the stage of keratoconus, especially in the early stages, it may be possible to combine corneal cross-linking with topography guided PRK laser eye surgery to reduce irregular astigmatism, resulting in clearer vision.  Dr. Wu is an expert in surgical treatment options for keratoconus.  She was the first surgeon in California to perform corneal crosslinking when it became FDA approved and commercially available in 2016.     

Corneal Cross-Linking

Corneal cross-linking strengthens and stabilizes your corneas by creating new links between the collagen fibers inside your cornea. The procedure begins with the removal of the corneal epithelium, the outermost layer of the cornea. Next, a solution of riboflavin (vitamin B2) is applied to the cornea, and then ultraviolet light is used to stimulate collagen cross-linking. As the new collagen bonds form, your cornea becomes stronger and more resistant to deforming.   

Topography-Guided PRK Laser Eye Surgery

PRK is a type of laser eye surgery used to correct your vision, improving blurriness due to refractive errors such as astigmatism, nearsightedness, or farsightedness.  It works by reshaping the middle layers of the cornea with a laser after removing the corneal epithelium. 

Topography-guided PRK laser eye surgery uses advanced imaging to detect and treat corneal irregularities caused by irregular astigmatism and higher order optical aberrations which cannot be treated with glasses. Topography-guided PRK is particularly beneficial for patients with mild to moderate keratoconus that do not tolerate glasses or contact lenses.  

EVO Visian ICL

For patients with thin corneas and advanced keratoconus, visual correction options usually include a hard contact lens, such as rigid gas permeable lens, hybrid lens or scleral contact lens.  For patient’s intolerant of hard contact lenses, the EVO Visian ICL is a great option to improve uncorrected vision and reduce dependence on glasses.  The procedure involves inserting a biocompatible lens inside the eye, sometimes called an implantable contact lens.  The implant is not visible externally and requires no maintenance.

What is Recovery Like After Corneal Cross-Linking?

Immediately after treatment, you can expect blurriness, sensitivity to light, and irritation. You will receive eye drops to apply as directed. Your corneal epithelium regrows naturally in 3-5 days. You can usually return to work within a week and your usual routine, including most types of exercise. You may notice glare around lights and other visual changes as your corneal epithelium heals. 

Request a Consultation

We’d love to help you get all the information you need in order to make the best choice for your eyes. Request a consultation today! Our staff is available and happy to answer your every question.

What Results Will I See With Keratoconus Treatment?

Corneal cross-linking stabilizes your corneas, preventing the condition from progressing.  You will notice changes in your vision for up to several months after corneal cross-linking treatment. Once your cornea shape stabilizes from corneal cross-linking treatment, you and your doctor can discuss options for further visual correction depending on your lifestyle goals and prior experience with contact lenses.  Dr. Wu will recommend the best option for visual correction based on your unique situation. 

Am I a Good Candidate for Keratoconus Treatment?

If you are recently diagnosed with keratoconus, getting evaluated for treatment early offers the best chance to prevent progression and the best visual outcome. Anyone with keratoconus is a good candidate for treatment, and we will develop an individualized treatment plan based on your needs. Which treatments will work best for you depends on the stage of your condition, how it progresses and your age. Fortunately, most people will keratoconus no longer need corneal transplants, especially if their condition is diagnosed and treated in the early

 Stages. Get a consultation with our experienced cornea specialist to see your best treatment options. 

Dr. Wu is one of the best Healthcare providers I’ve had to pleasure and good fortune to me. She is a straight shooter and takes personal ownership of your eyecare needs. She is a pleasure to work with her for my wife and son’s medical needs. I highly recommend Dr. Wu.
Jim L.

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Want to know more about keratoconus treatment? Please fill out the form on this page or call (949) 208-9090 to schedule your appointment.

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