Treatment may spare some from cornea transplant

September 6, 2013 12:54:06 AM PDT
Needlework is a passion for Bobbie Pulido, but one that was in danger of unraveling as her eyesight began to fade.

"I thought I was going to go blind. It terrified me. For me to lose my eyes would mean losing the ability to do the things I love," she said.

Pulido was diagnosed two years ago with keratoconus. It's a degenerative eye condition that weakens the cornea, causing it to bulge and lose shape.

San Leandro ophthalmologist Dr. Nicholas Batra says some cases are so severe they require a cornea transplant, which means weeks of recovery, along with a serious side effect.

"Corneal transplants do work for keratoconus, but they come with a side effect of not being able to lift more than 20 pounds for the rest of someone's life," he said.

Instead he recommended an investigational procedure for Bobbie now in clinical trials here in the U.S. It's known as corneal cross-linking and Batra Vision Medical Group is on the trial sites.

"This works by removing the skin of the eye, using a medication called riboflavin which is a vitamin, and a series of ultraviolet light," Batra explained.

After first numbing the eye, Batra uses a microscope to guide a hand-held device, carefully removing the top layer of the cornea. Next he applies multiple drops of riboflavin into the patient's eyes in a timed sequence over about 20 minutes.

Finally, he guides a device known as the Avedro KXL into place.

The patients' eye glows a fluorescent green as the ultraviolet light interacts with the riboflavin drops.

Researchers say the process causes collagen molecules in the cornea to bond, or cross-link, strengthening the tissue.

"By linking it, it's not going to push forward, it's much stronger. Think of putting mesh on a dam," Batra said.

After the treatment patients are able to go home with a simple eye patch, and the promise of improved eyesight, and a normal life.

For Pulido, the procedure has already stabilized her vision and allowed her to see well enough with glasses to pursue the delicate work she loves.

"For me it's being able to know that now I'll be able to see and do the things I like to do," she said.

Since the procedure is still investigational, it's typically not covered by insurance and patients must qualify to participate in the research. The out of pocket cost for patients participating in the trial average about $4,000.

Written and produced by Tim Didion


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