When Vision is Important see Expert Rajesh Khanna MD
Keratoconus Eye Disorder is a weakness of the Cornea. The thin collagen cornea fibers are unable to support the inner fluid of the eye. The cornea bulges forward affecting integrity and vision of the eye.
Cause or etiology: Genetics, Rubbing of the eye
Symptoms and Signs: Headache, poor vision inspire of glasses and contact lenses. Frequent change of prescription
Diagnosis: Color cornea topography, Pachymetry maps with OCT
Early Intervention with FDA approved technology: Cornea cross linking with Riboflavin (CXL) can halt the progression of Keratoconus. Classic Dresden protocol using Avedro Phtorexa Dextran is recommended in teenagers and young adults. Laser placed intacs ring segments lift up the bulging eye improving vision and decreasing higher order aberrations. Financing and Insurance coverage.
DALK or Deep Anterior Laser Keratoplasty is a partial thickness corneal graft. Its is sutured in place. Safer than a full thickness corneal graft it removes the diseased cornea while preserving the normal endothelium.
Many patients are unaware they might have keratoconus and they see their eye doctor because of increasing spectacle blur or progressive changes in their prescription. In many instances even a good refraction yields poor vision. Keratoconus should be diagnosed by a cornea specialist who may see typical findings when examining the patient at the slit-lamp.
In early forms of the disease there may be no obvious finding on slit-lamp evaluation and the diagnosis is made by computerized video keratography only. Keratoconus can start at puberty and progresses to the mid thirties at which time progression slows and often stops. Because it affects the young primarily, Keratoconus is a serious eye disease.
Keratoconus treatment here in Los Angeles depends on your symptoms. When your symptoms are mild, your vision can be corrected with eyeglasses. Later you may need to wear special hard contact lenses to help keep vision in proper focus. However, a permanent treatment to Keratoconus does exist.
New research suggests the weakening of the corneal tissue that leads to keratoconus may be due to an imbalance of enzymes within the cornea. This imbalance makes the cornea more susceptible to oxidative damage from compounds called free radicals, causing it to weaken and bulge forward.
A number of surgical options are available to the keratoconus patient. Since keratoconus can vary widely from patient to patient, the proper recommendation of any of these procedures depends on the individual nature of your problem.
Now, doctors can perform multiple types of corneal transplants, including deep anterior lamellar keratoplasty (DALK). DALK has emerged as the preferred transplant approach for keratoconus in most countries, although penetrating keratoplasty (PK) remains more popular in the United States.
One of the perceived advantages of DALK is that there is no risk of endothelial rejection, which should result in a higher likelihood of long-term allograft survival.
Dr. Khanna and the Keratoconus experts at Khanna Vision Institute are leading edge Los Angeles experts in the latest treatment options for Keratoconus. Dr. Khanna offers both DALK, Intacs for Keratoconus, and Cornea Cross Linking Riboflavin. Together, these leading treatments can help stop the progression of Keratoconus. Contact Dr. Khanna to get the latest technologies available for Keratoconus.
Keratoconus Doctor Khanna is here to help you attain better vision.You or your loved one plagued by keratoconus eye disease may be a teen, a young adult or more mature. If you are suffering from keratoconus eyes disease, you need somebody compassionate to help you. Glare, difficulty in driving may be preventing you from living your life to its full potential. Let us introduce you to expert keratoconus surgeon Dr Rajesh Khanna.
He has been in the field of eye surgery for over twenty five years. He has been helping people see better for a long time. His passion to help people with Keratoconus eye disease led him to get specialized training in hard contact lens twenty years ago. He realized these lenses were very troublesome. They caused irritation, redness and even fell off the eye. Worse they caused scarring of the cornea by rubbing against the bulging cornea. Dr. Khanna decided to get further medical and surgical training in keratoconus at University of Cincinnati in mid nineties.
Keratoconus Surgeon of Los-Angeles
Dr.Khanna has been performing insertion of Intacs for over a decade. In fact he was amongst the first in Los Angeles to master the art and science of intacs technology. He was certified by the manufacturer of intacs – Addition Technology. As his experience grew he imbibed new technology. Dr.Khanna now even implants newer thicker ring segments. He loves extreme precision in keratoconus eyes. He has evolved from the mechanical prolate system for intacs insertion to laser guided intacs placement. He acquired an ocular coherence tomography to map the thickness of the cornea suffering from Keratoconus. He calculates a predetermined depth to engage the laser for channel creation. Than he effortlessly slips the ring segments in.
Younger patients with Keratoconus require early intervention with Cornea cross linking with Riboflavin. Dr. Khanna performs Cxl or epi on cross linking to halt the progression of keratoconus. His calm nature helps the teenagers and young adults to undergo this therapy
#1 Keratoconus App by Keratoconus Doctor of Los-Angeles
His vast expereince in treating keratoconus eye disease and improving lives has led him to create the most popular app on keratoconus treatment.
Can any eye doctor surgically treat Keratoconus eye disease?
Experts in Keratoconus are best suited to treat keratoconus eye disease. An eye doctor has to have attended medical school, an ophthalmology residency and fellowship training in cornea and keratoconus.
Can my optometrist perorm cornea cross linking?
No optometrists are not allowed to perform this procedure. Only skilled surgeons are permitted to do so.
Can any ophthalmologist do Intacs insertion?
EYE MD or an ophthalmologist has to be trained and certified in Laser Intacs insertion and cornea cross linking.
Crosslinking FDA approved. We are happy to announce that USA is now on par with the world. FDA after careful consideration has said cross linking is safe for treatment of Keratoconus.Avedro based in Massachusetts is the company, worked hard to get cross linking of cornea approved.
Cross Linking for treatment of Keratoconus has thus far been done only in FDA studies or off label in the US. Therefore it had been expensive. The protocols were often restrictive.Many doctors were hesitant to prescribe it for their patients.FDA approval will allow many more patients to seek treatment for their bulging corneas. In many patients it may be curative.
Keratoconus is a disease where the front clear part termed cornea is weak. It bends under outward pressure from the fluids inside the eye. This disease is rampant in the teenage years. It is often missed. Optometrists do not perform this exam as part of annual exam. Advanced diagnostic technologies like OCT tachometry map and color cornea topography help to detect it. Intervention in teenage years can save sight. All school going children should have this simple test performed and analyzed by a Corneal Keratoconus specialist.
Cross linking works by increasing the strength of the cornea. A strong cornea is able to tolerate the forces from within the eye. This prevents the further bulging of the eye. When cross linking is performed in the teenage years it decreases the progression of the disease. The positive effect can last over a decade. By than the normal progression of the disease is naturally slowed down.
Lear more about Management of Keratoconus eye disease by downloading the Keratoconus app. This app has been developed for non medical people to figure out what is best for them. Please click on the icon below
Crosslinking FDA approval and Medical Insurance coverage
FDA approval will also allow insurances to cover the treatment. This will make the intervention by CXL affordable for people. A cat code code will soon be available. Financing options are also available.
Hypotonic Riboflavin Collagen Cross Linking for Thinner Corneas
By Rajesh Khanna, MD
Collagen cross linking has recently been invented in this century. A lot of people who would benefit greatly from this novel treatment have missed the recommended inclusion criteria. This has been because either their cornea has thinned out too much, developed scars or become very steep. keratoconus doctors strive to gel these patients living with keratoconus.
Researchers like Peter Hersh MD have led the way to help keratoconus sufferers. For thinner corneas a novel approach has been designed. Hyoptonic Riboflavin is with less salt and no dextran. This leads to swelling of the cornea. Normal concentration riboflavin on the other hands leads to corneal thinning. The thickness of the cornea is important to proven the uv radiation reaching the inner cells of the cornea.
18 years of age or older
A diagnosis of progressive keratoconus or a diagnosis of corneal bulging following Lasik eye surgery or PRK
Vision with contact lenses or glasses is worse than 20/20
Corneal thickness greater than 300 microns at the thinnest point
Cornea pachymetry >400 microns
Corneal pachymetry ≤ 300 microns at the thinnest point .
Previous ocular condition (other than refractive error) in the eye(s) to be treated that may predispose the eye for future complications
Clinically significant corneal scarring in the CXL treatment zone
Pregnancy (including plan to become pregnant) or lactation during the course of the study
Patients with nystagmus or any other condition that would prevent a steady gaze during the CXL treatment or other diagnostic tests.
Patients with a current condition that, in the investigator’s opinion, would interfere with or prolong epithelial healing.
Depending on the situation patients younger than 18 can be treated. Utilizing general anesthesia even uncooperative kids, people with nystagmus can benefit from this sight saving cure.
Keratoconus is a disease of the cornea where there is structural abnormality. The fibers in this clear part of the eye are not able to withstand the pressure from inside the eye. The weakened cornea is pushed forward and than pulled downward by gravity. The center part from where we see is pushed out farthest giving it a conical shape. The covering of this thin part, the epithelium is also very thin. These anatomical eccentricities cause physiological and optical aberrations leading to poor sight.
If we could reestablish the structure of the cornea it would lead to restoring of the vision of the eye. This implies regenerating the corneal fibers using stem cells. Investigation is underway for this holy grail in the cure for keratoconus. Research is also being conducted to prevent onset of keratoconus. Scientists are identifying the genes responsible for the condition. They would than develop gene therapy to alter expression of the problematic genes.
These futuristic scenarios are good and rosy. This vision of keratoconus free world drives the inventors to work hard. Lets not lull you into inaction while waiting for these developments which may be decades or even centuries away. Currently the cure for keratoconus is corneal cross linking.
There are various names assigned to this treatment. Some call it CXl, others label it as cornea cross linkage, corneal cross linking, cornea cross connections, corneal collagen cross linkage – Riboflavin (C3R). More important than what it is called is how it works.
CXL stiffens the weak cornea and imparts strength to it. This fortified cornea is able to withstand the pressure of the eye and thus halts the progression of keratoconus. The treated stiffer cornea also flattens improving the vision.
Its funny that our LASIK Institute is on the border of ventura and LA county. So we are close to cities in ventura county like Camarillo, Ventura, Oxnard and Dos Vientos
Camarillo is down the hill. Our refractive surgery centry is one of the only few around. We do LASIK, PRK, Superlasik, Intacs, Visian ICL, Restor multifocal IOL.
Our goal is to do whats best for you. Ventura lasik vision correction is certainly an option for you.
So ventura residents what are you waiting for? Did you know Ventura county lasik surgeon- Dr. Khanna has been voted favorite by readers of ventura county star for many years in a row. He has helped many people including your friends neighbors. Trust the best. Come and get a free evaluation. See if you like him and can place your faith in one of the top experts in the field of lasik eye surgery. Ventura lasik eye surgery has never been so affordable.