Corneal cross linking in Tampa at the Bay Area Eye Institute
Avedro, Inc., an ophthalmic pharmaceutical and medical device company, received FDA approval in 2016 for corneal cross-linking, a medical procedure that combines the use of ultra-violet (UV) light and riboflavin (vitamin B2) eye drops.
Corneal Cross-linking system by Avedro
Dr. Craig Berger is excited to offer FDA approved corneal collagen cross-linking with the Avedro KXL system for keratoconus in his Tampa Bay, Florida ophthalmology practice!
Corneal Collagen Cross-Linking:
- Creates new corneal collagen cross-links
- Results in a shortening and thickening of the collagen fibrils
- Leads to the stiffening of the cornea and stabilization of the disease
Corneal cross-linking provides patients a much-needed option to treat this debilitating disease. Patients suffering from progressive keratoconus can now receive a therapeutic treatment that has been rigorously tested and approved.
Corneal Collagen Cross-Linking Results:
- Stops progression in 88% of cases.
- Shown to be stable after 10 years in 95% of patients.
- Demonstrated an average improvement of 1.6 Diopters of cornea flattening.
- Decreased cornea astigmatism 2.0 Diopters or more in 32% of patients.
- Improvement of 2 lines or more of corrected distance visual acuity in 24% of patients.
How Does Corneal Collagen Cross-Linking work?
- CXL combines ultra-violet (UV) light and riboflavin (vitamin B2) drops
- Absorption of UVA by riboflavin generates free radical to form new corneal cross-links
- Results in a shortening and thickening of the collagen fibrils
- Stiffening of the Cornea
Cross-links are formed predominantly at fibril surfaces and within the protein network surrounding the collagen.
Since FDA approval in 2016, Dr. Craig Berger and his experienced team has helped hundreds of keratoconus patients with this minimally invasive in office treatment.
Proven to halt progression, corneal collagen cross-linking for keratoconus is AVAILABLE at the Bay Area Eye Institute in Tampa, Florida.
Experience matters when choosing where to have your cross-linking. Dr. Berger is a cornea fellowship trained surgeon with over 20 years experience caring for keratoconus patients. He has successfully treated hundreds of keratoconus patients saving them from further loss of vision and the possibility of needing a cornea transplant. In addition to cross linking he and his staff offer the latest in contact lens technology. For those who cannot be helped with cross linking or contacts he excels at cornea transplants. No matter what stage of keratoconus you have, Dr. Berger can help!
Call (813) 265-6940 today to schedule your appointment today for your keratoconus evaluation and find out which treatment is right for you!
KERATOCONUS QUICK FACTS
Affects 1 in 2000 in the United States
Affects all ethnicities & both genders
First diagnosed in young people at puberty or in their late teens
Progressive until the 3rd – 4th decade
Collagen Cross Linking Frequently Asked Question
How long do I need to be out of work or school?
After cross-linking, most individuals will need about five to seven days to recover before returning to work or school. During the first month, vision will fluctuate and there may be mild headaches as a result. The use of artificial tears every few hours while on the computer or while reading will help with any discomfort.
How quickly can I use electronics (computers, cellphones or video games)?
You may use electronics as soon as it is comfortable for you. You do not have to limit these activities as they will not cause any harm.
When can I resume contact lens use?
If you are currently wearing contacts, you may resume wear after the corneal epithelium heals in and the bandage contact lens placed at the end of your procedure is removed by your doctor. This usually occurs around day four or five.
What can I expect during my postop period?
Everyone has some degree of light sensitivity. It is normal for your vision to be blurry about a week after the cross-linking. Fluctuations can last up to a year but tend to improve over the first few months. Discomfort is usually mild. For the first week or so, a burning and foreign body sensation is very common. Rarely some patients will have significant pain. Pain medication will be prescribed to use for any postoperative pain that you experience. Most of these symptoms improve over the first few days to few weeks after your procedure.
When can I update my eyeglasses or contact lenses?
We recommend waiting a minimum of three months before updating your eyeglasses and/or contact lenses if possible. They can be updated sooner, but changes in your prescription will likely be needed with additional expense.
How long will cross-linking last? Will it have to be redone?
FDA studies show 88% of patients will stabilize (not progress) after a single treatment. Longterm studies show that it is effective for at least 10 years, possibly a lifetime. Approximately 12% of patients can progress after one treatment. If this occurs, the procedure can be easily and safely repeated.
How soon can my second eye be done?
If your second eye is progressing, it can usually be treated two to three months after the first eye is treated. Each case/person is different. This will depend on many factors.
When can I resume normal activities for example working out, running and swimming?
No swimming or hot tub use is allowed until after your epithelium heals completely and your bandage contact lens is removed by your doctor. This usually occurs around day four or five. Exercising as tolerated is perfectly fine following your procedure.
What will my vision be like after the procedure?
You should expect lots of fluctuations in your vision during the first two to three months after your procedure. Initially, the vision will be blurry, then can improve at about a week but many patients experience a drop in vision at about four to six weeks. Then the vision can improve at two to three months and beyond.
What is the difference between epithelium on and epithelium off?
Epithelium off is the only FDA-approved version of the procedure at this time. The epithelium is gently removed at the start of the procedure to allow penetration of the riboflavin and oxygen required for the cross linking to occur. Epithelium on is currently experimental and leaves the outer layer of the cornea intact.
Can I shower or wash my face or use makeup after the procedure?
You can shower and wash your face as long as you do not get any water directly in your eyes. Makeup should be avoided for the first week until the epithelium completely heals.
What will happen if I get something in my eye or rub it?
If you get something in your eye in the first week, please try not to rub. We recommend you gently irrigate your eye with preservative-free artificial tears.
Case Studies
Case #1
34 year old male with Keratoconus and irregular astigmatism with very poor vision.
Pre-op
Vision in his left eye: 20/400
Prescription is his left eye: -16.00+8.00 x 190
TREATMENT: Corneal cross-linking
Post-op
Vision in left eye: 20/70
Prescription is his left eye: -13.25 +5.00 x 35
Corneal topography is a non-invasive medical imaging technique for mapping the surface curvature of the cornea.
Case #2
43 year old female with Keratoconus and irregular astigmatism, long-term scleral contact lens wearer.
Pre-op
Vision in his left eye: 20/50
Prescription is her left eye: -4.50+1.50 x30
TREATMENT: Corneal cross-linking
Post-op
Vision in left eye: 20/30
Prescription is her left eye: -4.50 + .75 x40
Corneal topography is a non-invasive medical imaging technique for mapping the surface curvature of the cornea.
From one of our happy patients…
My boyfriend who has Keratoconus for years. Just recently become a patient of Dr Berger. I must say that Dr Berger who is also a medical doctor, is excellent and kind. Even though it seems that he is a man with a few words, he is clear and precise with his care. Vision is very important. Yet, there are very few eye doctors there who actually care because eyes are not theirs that they have to care for.
My boyfriend becomes his patient because of the progress of his condition (Keratoconus). Unlike the others, most eye doctors and staff who will normally say “just avoid sunlight” or “put more eye drops in” , Dr Berger looks into his “eyes” carefully and treat them with caution. We did make the choice to have the first cross linking surgery. He is healing so far. I am confident that the outcome will be great and he will be ready for the next one (for the other eye).
I believe that Dr Berger has very keen medical judgement and genuine concerns for patients. I would highly recommend him to any of my loved ones. On top of that, his staff is the A-team. I can’t name all the staff at his office. Yet, they are all beyond exceptional. After all, I am writing to say thank you because with the stress that I was going through with my loved one who could potentially lose sight/vision, I am grateful that having this whole team by our sides. (As I am also in the healthcare field for over ten years as a registered nurse, I sincerely would like giving credit to Dr Berger and his group of staff on this platform.)
Thank you! ~W.S.
