What is corneal cross linking?
Patients of progressive Keratoconus are advised Corneal Collagen Cross Linking C3R to halt the progression. When progression of Keratoconus is documented, either on Topography or increase in spectacle powers, this treatment called C3R Surgery or CXL needs to be done.
Corneal Collagen Cross-linking with Riboflavin (C3R Surgery) has been demonstrated in Europe to strengthen a weakened corneal structure. Corneal Collagen Cross Linking is done with Riboflavin, which is a vitamin solution used to soak the cornea and then exposed under Ultraviolet- A light. This photochemical reaction increases the linkage between the collagen fibres of these weak corneas. This treatment has been shown to halt the progression of the condition, though not reverse it.
Once the procedure is done, the cornea stabilizes over a period of 2-3 months, after which the patient will be re-evaluated for need of glasses or contact lenses.
LASER with cross linking
This is a relatively new procedure done for Keratoconus patients who have a small spectacle number and good corneal thickness. Here a specialized laser is first used to minimize the number, and then the regular cross linking is performed. It can only be done for a select few cases, and still the patient may require glasses or lenses even after the procedure.
It is important for the patient to know that this laser will only regularize and maybe reduce the spectacle power, but will never give precise outcomes like that in LASIK because the cornea is irregular to begin with.
The C3R / CXL surgery is a procedure which is done to halt further progress of the corneal bulge which is caused due to a disorder called Keratoconus.
CXL / C3R surgery causes the collagen strands in the eye to stiffen and get crosslinked and re-attached to each other, thus making the cornea stronger and more stable which in turn credibly halts the progression of the disease.
The CXL / C3R surgery takes approximately 30 minutes to 1 hour for each eye. (based on different types of machines). The procedure is done by using anesthetic eye drops (also known as topical anesthesia). Riboflavin eye drops are used to soak the cornea, this takes 20-30 minutes and then the eye is exposed to UVA light.
Patients who suffer from progressive Keratoconus are the ideal candidates the CXL / C3R surgery.
The CXL / C3R surgery is a first line of treatment for keratoconus and it is the only approach to halt the progression of keratoconus.
Most patients require the procedure only once in their life. Rarely the condition may worsen in patients with severe eye allergies/ eye rubbing, and they may require a repeat procedure. Nonetheless regular follow up visits must be done by your doctor.
Certain pre-operative instructions must be followed before undergoing the CXL/ C3R surgery, they are as follows:
Make sure to have someone to accompany and take you home on the day of your procedure.
Consume a light meal and keep yourself hydrated with fluids on the day of your procedure.
Do not wear any eye makeup, cologne or perfume on the day of your procedure.
Do not plan on going for a vacation, flying or swimming for a week or two after your procedure.
Limit your sun exposure for the first 2 months after your procedure.
After the C3R / CXL surgery patients can mostly resume their normal activities within just a few days to an entire week. It all depends on their recovery/healing rate and the nature of their profession.
Laser based Cross Linking is a procedure where a laser is done to reshape the excessively conical cornea and make it less steep, to improve visual outcome along with stabilization of the cornea.
This does not remove the spectacle number, but will help improve basic vision of the patient , with and without glasses.
Due to newer developments in technology, we now have various riboflavin formulations and the capability to deliver higher fluency procedures with customized treatment patterns.
AVOID EYE RUBBING
Certain instructions have to be followed before and after the CXL/ C3R surgery they are as follows:
Consume a light meal and keep yourself hydrated with fluids on the day of your procedure.
Do not wear any eye makeup, cologne or perfume on the day of your procedure.
Post the C3R / CXL surgery, a soft 'bandage' contact lens is put in place for seven days. Numerous different drops and painkiller tablets have been prescribed to you. It is vital to keep your eyes lubricated with your eye drops to allow the surface of the eye to recuperate during the weeks after procedure.
YES. It is a medical condition which needs treatment and hence is eligible for treatment. Check with your insurance company for more details.
The C3R / CXL surgery expenses can vary based on the medical facility and type of procedure. You can expect the cost to range from Rs. 30,000 to 70,000 and additional costs if combined with the laser treatment. It is depending on numerous aspects like surgeon fees, anesthetist, hospital charges, laser charges and more.