Keratoconus & Corneal Cross-Linking

Corneal topography showing Keratoconus in a patient’s eye.

Corneal topography showing Keratoconus in a patient’s eye.

What is Keratoconus?

The clear window at the front of your eye is called the cornea.  It looks coloured but the coloured part is actually inside the eye and is called the iris.  Most people have a cornea that is shaped like a soccer ball but people with keratoconus and pellucid marginal degeneration have corneas that have a more conical shape like a rugby ball.  This causes severe distortion of the patient’s vision that cannot be corrected by glasses.

How is Keratoconus treated with laser?

The 3 most important steps in treatment

  1. Stop rubbing your eyes - It is critical that patients with keratoconus control their ocular allergies and not rub their eyes. 

  2. Stabilise the progression of the disease – Typically keratoconus progresses until you are in your mid 30’s. (Pellucid Marginal Degeneration progresses for much longer than this).  Corneal collagen cross linking is a laser procedure that stabilises the progression of keratoconus. 

  3. Get great vision again – For most patients this will involve seeing an optometrist specialising in complex contact lenses.  Specialist optometrists can now fit almost any keratoconic patient with comfortable lenses giving them great vision. 

Unfortunately, some people can’t tolerate these lenses or are allergic to the solutions used to clean them.  In these cases, a customised laser treatment called corneal regularisation, topography guided PTK, or the Athens protocol can be used.  In this procedure the conical and irregular part of your cornea is removed with the laser.  Immediately afterwards your eye will have corneal collagen cross-linking to ensure the new regular shape of the cornea is stable. 

What is Corneal Collagen Cross-linking?

Corneal collagen cross linking is a procedure that is used to strengthen corneas that are weak due to keratoconus or pellucid marginal degeneration and can also be used to treat infections in the cornea.   

The procedure involves soaking your cornea in riboflavin and then applying an ultraviolet light to the soaked cornea.  This induces a chemical reaction called cross linking that makes the corneal more rigid. 

Our doctors perform collagen cross linking for patients with private health insurance for the “known gap”. This means your fees are capped depending on your insurer between $0 and $500. You can also have intravenous sedation for the procedure.  If you do not have private health insurance, Dr Cronin and Dr Gunn have a dedicated outpatient major procedure room so that you can minimise your cost and maximise your medicare safety net benefit.