Cross-linking Corneal Treatment

Manhattan corneal surgeon Sandra Belmont, MD, FACS, is committed to staying at the forefront of advancements in ophthalmologic technology and techniques. Thanks to her dedication to being a forerunner in her field, Dr. Belmont is able to offer suitable candidates innovative corneal collagen cross-linking treatment, often simply referred to as “cross-linking.” Dr. Belmont may suggest this procedure for patients with corneal disease who are not yet ready to pursue a corneal transplant.

Cross-linking was first developed in Germany in 1998. It is used routinely throughout Europe and in other countries for the treatment of certain corneal diseases. It is currently undergoing U.S. clinical studies before the FDA approves it for use in treating keratoconus and other disorders affecting the cornea.

The Aim of Cross-Linking

Cross-linking is a developing treatment for early-stage keratoconus — a condition in which the cornea becomes irregularly steep, making it difficult to wear contact lenses and impairing vision as the condition progresses — and other types of corneal disease.

The objective of cross-linking is to strengthen the cornea and stop the keratoconus from progressing, if possible, helping the patient avoid the need for corneal transplantation. However, cross-linking is not a cure for keratoconus, and the patient will still need to use glasses or contact lenses following treatment. Dr. Belmont may suggest cross-linking treatment in conjunction with another corneal disease treatment, such as Intacs corneal implants.

How Cross-Linking Works

Collagen cross-links are the naturally occurring “anchors” in the cornea which are responsible for keeping the cornea from becoming too steep and bulging out. With cross-linking treatment, Dr. Belmont administers custom-made riboflavin (vitamin B2) drops to the eye, saturating the cornea. She then activates the riboflavin with the use of an ultraviolet (UV) light. This process increases the number of collagen cross-links in the cornea, which in turn strengthens the cornea.

There are two main types of corneal cross-linking: epithelium-off and epithelium-on (transepithelial) cross-linking.

With epithelium-off cross-linking treatment, Dr. Belmont first removes the thin layer that covers the surface of the eye. This allows the liquid riboflavin to penetrate the cornea faster.

With transepithelial cross-linking treatment, Dr. Belmont leaves the epithelial surface of the cornea intact, but it takes the riboflavin longer to penetrate the cornea with this approach.

Additional Potential Applications for Cross-Linking

Aside from treating early-stage keratoconus and other corneal disorders characterized by corneal weakness (ectasia), cross-linking may potentially be used to treat corneal ulcers that do not respond to topical antibiotic treatment. Also, cross-linking can be used to strengthen the cornea before LASIK surgery, during which Dr. Belmont reshapes the curvature of the cornea to correct the refractive error causing poor eyesight.

What to Do If You Suffer From Keratoconus or Another Corneal Disease

If you have been diagnosed with early-stage keratoconus or another corneal disorder that has made your cornea weak, you may be an appropriate candidate for corneal collagen cross-linking in New York City with Dr. Belmont. If you are interested in learning more about this innovative treatment option that may arrest the progression of your keratoconus and may help you avoid the need for a corneal transplant, you should schedule an appointment with Dr. Belmont to learn more. During your comprehensive consultation, she will perform a thorough examination of your eyes and review your treatment options with you.