Eyeworld

87 EW FEATURE September 2016 • Corneal collagen crosslinking Contact information Randleman: randlema@usc.edu Rocha: karolinnemaia@gmail.com Suh: lhs2118@cumc.columbia.edu Dr. Rocha added that in patients with RK, the postoperative vision fluctuates. There are several publica- tions showing that crosslinking after RK can help stabilize the vision, but randomized and longer-term studies are needed, she said. It's unpredict- able at this point. Although Dr. Suh has not per- formed crosslinking on RK patients, she thinks it could be helpful for those who have developed post-RK thinning and ectasia. Discussing crosslinking with patients When discussing crosslinking with patients prior to the procedure, Dr. Rocha said she will explain that the goal is to stop the progression of ectasia and keratoconus. Dr. Suh explains to the patient that keratoconus is a progressive condition where there is thinning and increasing astigmatism of the cornea due to instability in the cornea. "I explain that, in the past, there was no intervention that could be provided and that some pa- tients had significant thinning and scarring that necessitated corneal transplantation," she said. "I also emphasize that this condition starts early and that corneal transplanta- tion in a young, active individual could be precarious, as any trauma to an eye that has had a transplant could be potentially blinding." Crosslinking has been shown to stabilize the cornea and to avoid the need for future corneal transplanta- tion, Dr. Suh added. "Some corneas after crosslinking even flatten, so some patient can have improved vi- sion." However, in the vast majority of patients, vision stabilizes so that they can be comfortable and see well with their contacts or glasses, Dr. Suh said. Dr. Randleman said that when he discusses crosslinking with patients, he highlights why it's an option he's considering. The patient age and likelihood of progression also factor into the discussion. He added that it's important to discuss prior to the procedure what the outcomes could be like. It's also imperative to coun- sel patients to be realistic, he said, because any time they hear about a new treatment, they think it's going to be a cure. Many patients can ben- efit from crosslinking, but the results could still take time to manifest. The first week after treatment with epi-off is going to be uncomfortable, Dr. Randleman said. Vision may get worse over the first month before it starts to adjust and get better. EW Editors' note: The physicians have no financial interests related to their comments. 2 3 5 0 M i s s i o n C o l l e g e B l v d . , S u i t e 1 0 7 0 , S a n t a C l a r a , C A 9 5 0 5 4 T e l : ( 4 0 8 ) 4 5 5 - 9 7 5 2 i n f o @ m o v u - i n c . c o m w w w . m o v u - i n c . c o m S S - O C T P i o n e e r . …even for the most severe cataracts Swept Source OCT Biometry Fast, Accurate and Successful True real-time 2D imaging cornea to retina Visit Booth 365 at AAO 2016 Come See the Future of SS-OCT Biometry:

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