April 1, 2013 —When Timothy Hull first joined the Army National Guard at age 18, he handedly passed the weapons qualification course. After being diagnosed with keratoconus at age 22, Hull not only struggled to pass the marksmanship test, he couldn’t even drive, look at a computer screen or watch TV without seeing double. At age 32, Hull is now father to two daughters and has been able to halt the progression of this degenerative eye disease by participating in a clinical trial at Legacy Devers Eye Institute, which allowed him to undergo a new procedure called corneal crosslinking. Devers is the first and only eye care provider in Oregon to offer corneal crosslinking to its patients suffering from both keratoconus and post-LASIK ectasia—two degenerative eye diseases that affect the shape of the cornea and can lead to blindness.
Having been used in Europe since 1998 and Canada since 2007, corneal crosslinking has been proven as a safe and effective method of slowing the progress of corneal thinning from both eye diseases. The procedure is the only treatment available that can slow or halt the progression of these two degenerative and debilitating diseases. Other treatments such as uncomfortable hard contact lenses that flatten the cornea or invasive surgical treatments such as corneal transplantation may improve vision but cannot stop the progression of the disease.
Corneal crosslinking has not yet been approved by the United States Federal Drug Administration (FDA) and it is the hope of Devers Eye Institute’s associate director of Corneal Services, Michael Straiko, MD, that it will be in the near future. In fact, one goal of Devers’ clinical trial is to achieve FDA approval and make this treatment more widely available.
“Post-LASIK ectasia and keratoconus can prevent people from doing seemingly simple daily activities, such as driving a car because often times, they cannot even see stop signs,” said Dr. Straiko. “Corneal crosslinking offers hope and relieves anxiety for patients like Tim who are gradually losing their sight, and consequently their ability to lead normal lives free from vision challenges. Offering corneal crosslinking to our patients is the first time I have been able to offer a cure to patients like Tim. We urge the FDA to approve this sight-saving treatment so it can be more accessible and affordable for our patients.”
Specifically, corneal crosslinking involves removing the front layer of the cornea, which is called the epithelium; then applying riboflavin drops to the eye and then exposing the eye to an ultra-violet light. This non-invasive procedure does not require anesthesia and only takes about 30 minutes. Patients are sent home wearing a soft contact lens for about a week to help with healing and comfort after the procedure. Initial recovery time is estimated at one week and patients can expect to see stabilization or progressive improvement over the course of 6 to 12 months.
The total cost of the treatment and all follow up for 12 months is $3,200 per eye. Because it has not been approved by the FDA yet, it is not currently covered by insurance plans.
About Keratoconus and Post-LASIK Ectasia
Keratoconus is the second most common cause of corneal transplants in the United States and affects one in 2,000 people across the United States. Specifically, it causes the cornea to thin and gradually bend into a cone-like shape. The causes of the condition are unclear.
Post-LASIK ectasia is an eye disease that occurs in roughly one in 1,000 patients who receive LASIK surgery. The surgery weakens the inner layers of the cornea and over time, the weakened cornea can lose its shape and bulge forward, resulting in distorted vision. If not prevented or properly treated, it can cause permanent vision loss.
