Epi on or Epi off Crosslinking- that is the question

Keratoconus progression can be halted by corneal collagen cross linking has been established. We thank all our patients who believed and participated in the trials. Now the hot question is which is better- to remove epithelium or to leave it alone.The debate has recently become intense. Various specialists have filed trade marks, patents or invested in a particular technology. Sometimes their opinions seem biased. So where do we turn to if we want to know the true answer?

Riboflavin cornea cross linking
How about the FDA? They are experts at looking at the data and known for they unbiased opinion. They have the interest of American patients in mind.

They analyzed lot of safety data. Here is what they have approved in USA 

Epi off cornea cross linking 

So that means so far Epi off is better than epi on or it’s variations like c3R

The epithelium interferes in the seepage of riboflavin i the cornea. It also hinders the uniform transmission of uvA . Therefore it a good idea to remove it

Some may disagree and say FDA process is tedious and hence Epi on is still stuck somewhere. We can than turn to peer reviewed journals. No published study has ever shown that Epi on crosslinking is better than Epi off.

Multiple studies have shown that Epi on Cross linking is the current Gold Stsndard.

So we rest our case

Epi off cross linking is the procedure Keratoconus specialists recommend 

FDA approves epi off Cornea cross linking

Yes what we had been waiting for finally happened. Another arrow in fight against keratoconus . FDA looked at the safety and efficacy of riboflavin activated by uv A radiation in detail. They looked at the data submitted by Avedro. FDA said epithelium removed or epi off is a good option. 

This means if you have been waiting to make your cornea stronger the time has arrived. It may also mean your insurance may cover part of the cost. So send your insurance card to our keratoconus center. You may also qualify for no interest 36 monthly payment plan.

Unfortunately they have not approved epi on or c3r and other variants. So invest your money in the technique FDA considers more safe and result oriented. 

Come to our Beverley Hills center for keratoconus treatment and get an unbiased opinion.

Epi on cross linking and corneal sensitivity

A new study in journal of cataract and refractive surgery increases our knowledge of cross linking in keratoconus patients. Cross linking, as you may recall is a newer treatment for bulging cornea. The strength of the cornea is increased by adding riboflavin and activation it by UV radiation. This affects the nerves in the cornea.

This study on keratoconus patients undergoing cross linking compared the return of corneal sensation. It divided the patients into two groups. One group had epi off cross linkage and the other had epi on cross linkage.The Keratoconus experts analyzed the results. They came to the conclusion that the nerve sensation recovered in both methods. The recovery was faster in pi on or transepithelial corneal cross linking.

Currently the most efficous method for corneal collagen cross linking is the epithelium off Dresden protocol. Research in cross linking is further needed to make epithelium on more beneficial as it has quicker recovery and less patient discomfort.

Each individual eye is different. A keratoconus surgeon can discuss with you which treatment protocol would be best for your eye.

The Keratoconus center portal is back

Hi Keratoconus patients, doctors, Keratoconus experts and sympathizers

You will be all glad to know that our popular information portal is getting a overhaul. Technology upgrades and hacking had created problems with the discussion forum. Good news . That is going to be back in the next few weeks.So check back frequently.

We have a lot of information on Keratoconus on our portal. One of our first keratoconus sites gives an overview of keratoconus and its management.

http://www.Newintacs.com is focussed on causes of keratoconus. It delves in detail on history of progression, pathology, biochemistry and evolution on knowledge of the disease process.It provides information on affording these cutting edge treatments.

Now we are soon going to launch an entire site focussed on treatment of keratoconus Surgical treatments of keratoconus using advanced lasers will be presented. Age based appropriate cures will be shown. Each procedure will be accompanied by pictures and videos of surgeries. Patient feedback in form of written reviews, videos will be highlighted.

And a surprise…if you get bored by static sites, we have a smart genie that can interact with you to guide you to the answers you seek in the treatment of keratoconus

all coming soon.

will keep you updated

Cataracts in Keratoconus patients

Keratoconus as we have been reading on this site about keratoconus is a weakening of the cornea affecting quality vision. Cataracts, on the other hand affects the lens of the eye. It occurs when water enters the natural lens affecting its transparency. Our own Beverly Hills Keratoconus Expert Dr Khanna says” Cataract is a disease of older age where as Keratoconus occurs in childhood and youth.When a keratoconus patient grows older he ay develop cataract”. The problem in curing cataracts with keratoconus is finding a good surgeon proficient in Laser cataract surgery. The lens to replace the opacified natural lens. Two problems are faced by Los Angeles Cataract specialists treating Keratoconus patients suffering from cataracts. The first challenge is to get keratometry reading or the shape of the cornea.This is used in formula like srk-t or holladay. These mathematical expressions presume the front clear surface of the eye or the Cornea is round. In keratoconus as we know the cornea is of an abnormal shape. Many a time there are folds in the cornea, the epithelium is thickened. Sometimes the cornea with keratoconus may even have an opacity.

The second challenge in treating cataracts in keratoconus patients is choosing a good intraocular lens replacement. Toric lens could be helpful in such situations. Toric lens have astigmatism built in them.

Keratoconus with Catarct

A cornea trained surgeon who is adept at complicated cataract surgery  is the best person to handle your procedure if you are suffering from keratoconus and Cataracts. You are lucky that in Los Angeles area we have one. Dr. Khanna an expert in cataract surgery with lasers and treatment of keratoconus should be your choice to help you see better.

Posterior-corneal-elevation-detection

In this study done in Ibaraki, Japan, keratoconus and cornea researchers wanted to see whether  three-dimensional (3D) corneal and anterior segment optical coherence tomography (CAS-OCT) or  a rotating Scheimpflug camera combined with a Placido topography system (Scheimpflug camera with topography) was better to study the cornea. They wanted to see how it would be best to detect the signs of early keratoconus disease. Their goal was to asses if  normal eyes and forme fruste keratoconus could be separated based on that criteria. They found out that both systems worked equally good. Our own Los Angeles Keratoconus Expert feels an early cornea topography works equally good in the hands of an experienced keratoconus expert.

The Delicate eye

Eуе іѕ оnе оf thе mоѕt dеlісаtе ѕеnѕоrу оrgаnѕ аѕ іt асtѕ аѕ а саtаlуѕt fоr lіvіng thе lіfе ассоrdіng tо оur dеѕіrе. It іntеndѕ tо аdd а dіvеrgеnt flаvоr tо оur lіvеѕ ѕо іt dеmаndѕ а vеrу ѕресіаl саrе whісh саn bе ореrаtеd wіth thе hеlр оf а Pаѕаdеnа Oрtоmеtrіѕt. Thе mаіn рurроѕе оf Pаѕаdеnа Oрtоmеtrу іѕ tо рrоvіdе аn еxсluѕіvе vіѕіоn саrе, whісh іnсludеѕ реdіаtrіс аnd gеrіаtrіс ѕеrvісеѕ, оffеrіng оf соntасt lеnѕеѕ, trеаtіng thе раtіеntѕ ѕuffеrіng frоm осulаr аnd drу еуе dіѕеаѕеѕ.
Pаѕаdеnа Oрtоmеtrіѕt аdmіnіѕtеrѕ vаrіоuѕ kіndѕ оf соntасt lеnѕеѕ соnѕtіtutіng dаіlу dіѕроѕаblеѕ, twо wееkѕ оr оnе mоnth dіѕроѕаblеѕ оr tоrіс ѕоft соntасt lеnѕеѕ. Thеу еvеn рrоvіdе lеnѕеѕ fоr thе kіdѕ оf аll аgеѕ tаkіng саrе оf thеіr соmfоrt аnd tоlеrаnсе. Sо іf уоur сhіld іѕ kееn tо аррlу thе соntасt lеnѕеѕ, thеn уоu аrе frее tо соntасt wіth thе орtоmеtrіѕt Pаѕаdеnа fоr hаvіng а соntасt lеnѕ соnѕultаtіоn, whісh іѕ vеrу muсh rеquіrеd tо knоw thе dесіѕіоn оf thе сhіld. Thе Pаѕаdеnа Oрtоmеtrіѕt wіll сеrtаіnlу rеѕресt thе сhіld ѕ dесіѕіоn, thаt whеthеr hе оr ѕhе іѕ rеаdу tо hаndlе lеnѕеѕ.
Whіlе rеаdіng ѕоmе сhіldrеn fасе сеrtаіn vіѕіоn соmрlісаtіоnѕ whісh саn bе ѕоlvеd оut bу wеаrіng glаѕѕеѕ оr соntасt lеnѕеѕ. A vіѕіоn thеrару асtѕ аѕ аn іndіѕреnѕіblе wау оut fоr thіѕ рrоblеm. Thіѕ раrtісulаr thеrару іnvоlvеѕ еуе еxеrсіѕеѕ аnd ѕоmе оthеr nесеѕѕаrу асtіvіtіеѕ whісh аrе bеіng dеѕіgnеd fоr еnhаnсіng thе vіѕіоn ѕkіllѕ. Pаѕаdеnа Oрtоmеtrу ѕеrvеѕ thіѕ рrоgrаm іn а vеrу оrgаnіzеd mаnnеr. But bеfоrе gоіng fоr thе thеrару, уоur сhіld hаѕ tо раѕѕ оut thе vіѕіоn еxаm. Thіѕ еxаm іѕ mаndаtоrу аѕ іt wіll hеlр thе Pаѕаdеnа Oрtоmеtrіѕt tо аdvіѕе whісh рrоgrаm wіll рrоvе tо bе bеnеfіttеd fоr thе раtіеntѕ. If ѕоmеhоw thеу fаіl tо furnіѕh thаt ѕресіfіеd ѕеrvісе, thеу wіll rеfеr thеm tо еуе ѕресіаlіѕt wіthоut mаkіng аnу dеlау. Sо thеу undеrѕtаnd thе vаluе оf уоur сhіld ѕ lіfе. Thеу роѕѕеѕѕ аll thе lаtеѕt соntасt lеnѕ tесhnоlоgу. Aраrt frоm lеnѕеѕ, thеу аlѕо оffеr а wіdе rаngе оf ѕеlесtіvе glаѕѕеѕ wіth lаtеѕt dеѕіgnеd frаmеѕ bоth fоr thе mеn аnd thе wоmеn.
Pаnасеа Oрtоmеtrіѕt аlѕо trеаtѕ thе раtіеntѕ whо аrе ѕuffеrіng frоm осulаr dіѕеаѕе lіkе glаuсоmа, соrnеаl ulсеrѕ оr соnјunсtіvіtіѕ. If уоu аrе еxреrіеnсіng ѕеvеrе еуе раіn, frеquеnt rеdnеѕѕ thеn уоu аrе іn dіrе nееd оf mеdісаl аѕѕіѕtаnсе. Oрtоmеtrіѕt Pаnасеа аlѕо dеаl wіth thе реорlе gоіng thrоugh drу еуе рrоblеmѕ whісh іnсludе іnfеrіоr vіѕіоn quаlіtу, dаmаgе еріthеlіum оr mаgnіfіеd аѕtіgmаtіѕm. Thе рауmеntѕ fоr thе Pаnасеа Oрtоmеtrу саn bе рrосеѕѕеd оut bу thе mеаnѕ оf thе саѕh, Mаѕtеr оr Vіѕа саrd.
Sо іf уоur lоvеd оnеѕ аrе аfflісtеd wіth сruсіаl еуе оr vіѕіоn рrоblеm, thеn уоu аrе аdvіѕеd tо соntасt wіth thе Oрtоmеtrіѕt .
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