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Subspecialties Cornea / Ocular Surface, Practice Management, Business and Innovation, Health Economics and Policy

Incorporating Cross-Linking Into Your Practice

I have been performing corneal collagen cross-linking (CXL) for three years and it has resulted in a paradigm shift in the way we treat keratoconus in our practice, mirroring changes in the standard of care throughout the world. The procedure can have tremendous benefits for patients. According to data from the Dutch National Organ Transplant Registry, the percentage of corneal transplants for keratoconus decreased by approximately 25 percent during the three-year period after CXL was introduced (1).

I now have more than two-year follow-up on patients I have personally treated. What I have consistently observed in these patients is stabilization of their ectatic disease and often corneal flattening, as well. A few treated patients with mild to moderate keratoconus have even been able to achieve 20/25 or better uncorrected visual acuity at the two-year mark, while others are able to successfully correct their vision with glasses or soft contact lenses.

Beyond what this procedure does for patients, I also feel strongly that CXL is a necessary addition to the treatment options offered in any cornea practice treating patients with keratoconus. Offering CXL (see Figure 1) expands my scope of practice and completes the expertise I offer as a corneal specialist to referring doctors and their keratoconic patients.

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About the Author

Neda Shamie

Neda Shamie is a partner in the Maloney-Shamie Vision Institute and a clinical professor of ophthalmology at the Keck School of Medicine, University of Southern California, USA.

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