Corneal cross-linking is a treatment for an eye problem called keratoconus. Keratoconus is a degenerative disorder in which structural changes to the cornea cause it to thin and change to a more conical shape than its normal gradual curve. Keratoconus can cause substantial distortion of vision, including multiple images, streaking and sensitivity to light. It is typically diagnosed in the patient’s adolescent years and attains its most severe state in the twenties and thirties.
Keratoconus is not an uncommon disease with a prevalence ranging between 1 in 500 and 1 in 10,000. Most corneal specialists believe that the prevalence of this condition is actually higher than these estimates as current technology is now able to detect this disease at earlier stages and in more subtle forms. This is especially true of devices such as the Pentacam which can measure the cornea’s back surface.
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As with many conditions, the earlier the patient is treated, the better the results. In some countries, CXL is used in patients as young as 10 years old who are found to have forme fruste (pre-clinical) or frank (clinical) keratoconus. This first line treatment makes it much less likely that these patients will develop severe irregular astigmatism and progress to require corneal transplantation. It appears to be possible to actually prevent the development of keratoconus in some patients with pre-clinical signs of keratoconus if CXL is performed early.
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