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During this process the cornea (the clear window at the front of the eye) becomes thinner and more curved than it should be. As a result vision is blurred and distorted during teenage years then stabilizes later into adult life. At first spectacles improve vision. In time wearing glasses will be less helpful and contact lenses become the best vision solution. As keratoconus advances, contact lenses also become ineffective and corneal graft surgery is required.
Collagen Cross Linking induces tissue stiffening that stops keratoconus progressing, and research has shown that some patients also benefit from a partial reversal of their keratoconus as well. Collagen Cross Linking is a relatively new laser treatment, normally used for the treatment of teenagers and young adults, which stabilises and often partially reverses failing vision due to keratoconus. Collagen Cross Linking is effective in over 90% of patients and forms an important part of the treatment of patients with worsening keratoconus.
Your first step in treatment for keratoconus will be a consultation at one of the Laser Vision Scotland clinics. You will undergo extensive diagnostic testing until our consultants are confident that they are familiar with your condition. The is essential to ensure the treatment you receive is the most appropriate for you. Following diagnostic testing, your consultant will discuss treatment options. If collagen cross linking is the best option for you, a treatment date can be booked and your consultant will provide you with a full compliment of instructions to follow in the run up to your procedure.
Collagen Cross Linking is a painless day procedure lasting typically half an hour, and can be safely carried out using drops only for anaesthetic, or under general aesthetic if preferred. The eye is initially numbed with anaesthetic drops, and a special dye called riboflavin drops are washed onto the eye for a few minutes. The patient then looks at a blue light for 20 minutes, and during this time the dye and the light interact to stiffen the cornea through a process of linking together protein molecules.
After treatment most people return straight home, with a special contact lens in their eye for a few days to improve comfort. The treated eye is normally sore and watery for the first few days after treatment while the eye surface heals. Both surgeons like to know that their patients can contact them directly if there are any concerns before or after treatment, so make sure you have a card with their contact details for safe keeping.
Corneal graft surgery is more complex and takes longer than most other types of eye surgery, and is only carried out by a small number of eye specialists, and only in the expert environment of eye hospitals such as Laser Vision Scotland.
Common eye conditions that are treated by corneal graft surgery include keratoconus, corneal scarring after previous eye infection, cloudy cornea due to fluid retention and corneal injury. Depending on the exact nature of the corneal problem, your surgeon will advise whether it is necessary to replace the full thickness of the cornea or just the front or back surface.
Corneal graft surgery lasts between one and two hours, and is usually performed while you are asleep under general anaesthetic. Of all the organ transplants, corneal graft surgery is the most successful, with long-term graft survival rates of up to 90% or more.
In the United Kingdom there are a small number of specialist facilities (Bristol, Manchester) called ‘Eye Banks’ where corneal grafts are rigorously tested and stored prior to transplant surgery.
Following corneal graft surgery long term care is required including the use of daily eye drops, often for several years.