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Cross-linking Shows Promise For LASIK Complication

January 22, 2010

OSN Supersite, reporting from the Hawaiian Eye Meeting today an article titled:  Early U.S. cross-linking study results positive for treating keratoconus, ectasia.

Marguerite B. McDonald, MD, presented early results of the
prospective, block-randomized clinical trial of 292 eyes with either
keratoconus or post-LASIK or post-PRK ectasia. Maximum keratometric
value, best corrected visual acuity, uncorrected visual acuity and
manifest refraction are being measured in the study.

"The interim conclusions look pretty good," Dr. McDonald said. "It
halts the progression of keratoconus and ectasia after LASIK."

"We think it will become the standard of care for the treatment of corneal ectatic disease," Dr. McDonald said.

This is certainly exciting news.  Ectasia is one of the most difficult complications of LASIK surgery. It is a condition in which the cornea assumes a conical shape due to
weakness, thinning, and anterior bowing of the corneal surface in patients following LASIK.  These patients may  have a  progressive corneal thinning and bulging.

The key to preventing post LASIK ectasia is proper screening of patients prior to surgery.  Several risk factors exist including:

  • Thin corneas
  • Irregularities in corneal topography
  • Age
  • Removing too much corneal tissue

Current treatment regiments for ectasia include:

Cross-linking of the cornea is a new curative approach to re-increase
the mechanical stability of corneal tissue that is progressively
decreasing as a result of a corneal disease such as ectasia, keratoconus, or
pellucid marginal degeneration. The
procedure of corneal cross linking was developed from 1993 until 1997
by Prof. Theo Seiler and Prof. Eberhard Spoerl at the University of
Dresden. The first patients were treated in 1998. Today
corneal cross-linking is performed in more than 300 centers around the
world. In many centers it has the potential to become the standard
treatment for ectasia and keratokonus thus preventing the need for corneal transplant.  It is currently undergoing clinical trials here in the US.  I am anxiously awaiting its approval.

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