Corneal cross-linking is a state-of-the-art, FDA-approved, treatment for keratoconus, a condition in which a weakened cornea develops a cone-like bulge.
At Soroudi Advanced LASIK & Eye Centers, we deliver collagen cross-linking treatments with epi-on. This minimally invasive, outpatient procedure combines specialized eye drops and UVA light following refractive surgery, which triggers natural collagen growth, strengthening the cornea.
What can I expect from the procedure?
This procedure, when performed by Dr. Soroudi, involves the application of riboflavin drops (vitamin B2) directly onto the cornea. Once the drops have been applied, the eye is exposed to a specialized UV light source. The combination of the riboflavin and the UVA light causes the corneal structure to stiffen. The entire procedure takes only about 15 minutes to complete and is painless. Your eye will be held open during the procedure, so you don’t blink, but it is still comfortable.
Why is “epi-on” collagen cross-linking better?
Imagine your eye in a tanning bed! The difference with the epi-on treatment is that it is less invasive, as it leaves the epithelium (the thin tissue covering the cornea) intact. The word “epi-on” refers to “epithelium on,” a safer procedure that protects the cornea from infection and significantly reduces any pain or irritation after the procedure for a faster, more comfortable recovery.
Halting progressive keratoconus in its tracks
Corneal cross-linking is currently the only treatment that can stop progressive keratoconus from getting worse. And it helps you avoid the need for a corneal transplant, a major surgery.
Types of corneal cross-linking
There are two types of cross-linking: Epi-off and epi-on, “epithelium on” or “epithelium off.” The epithelium is a critical part of the eye structure, covering the cornea, and protecting it from infections and other damage. The epi-on procedure keeps this essential layer of the eye intact.
With the epi-on approach, Dr. Soroudi gently loosens the epithelium with eye drops before administering the riboflavin drops to ensure the vitamins reach into the cornea before the UV exposure. It is the combination that causes the cross-linking of the eye’s natural collagen and the strengthening of a weak cornea.
Preparing for your treatment
The day of your “epi-on” collagen cross-linking procedure, take a regular shower in the morning and do not apply makeup. Dr. Soroudi advises using a warm compress with baby shampoo scrub for ocular hygiene (you can purchase his patented Eye-press from CVS or online at www.eye-press.com) or a warm towel. Eat a normal meal, as there is no need to fast before the procedure. Arrange for another adult to drive you home after your procedure, or you can choose a driving service such as Uber, Lyft, or a taxi.
Candidates for collagen cross-linking with epi-on
Dr. Soroudi only recommends corneal cross-linking for clients aged 35 or younger. Those who are older than 35 generally have stable corneas. Many clients who have been to other eye surgeons were told that collagen cross-linking improves vision. This is false. This customized procedure does not reverse corneal changes that have already happened but will keep them from worsening. For comprehensive vision correction combined with collagen cross-linking, Dr. Soroudi may use Intacs, PRK, and other modalities to correct your vision and stabilize the cornea for the ultimate result.
Epi-on vs. epi-off
All surgeries carry some risk, but when under the care of Dr. Soroudi, you can be confident that a leading eye surgeon is performing your treatment with next-generation equipment.
During epi-off, the thin tissue covering the cornea is removed, which can lead to problems such as infection, light sensitivity, eye pain, swelling, eye damage, blurred or hazy vision, and other side effects.
The epi-on approach is far superior, much safer, and has a faster recovery time. Complications are rare with epi-on cross-linking, and that’s why Dr. Soroudi prefers this approach.