MDNews - Greater Kansas

"Typically, a 14-year old would get a transplant at age 22," Dr. Gangadhar says. In 44-year-old Mike's case, the condition was more stable in one eye, but continued to progress in the other eye into his 40s. Left untreated, the progression could have led to a corneal transplant, which is something he wanted to avoid. WHAT IS CORNEAL CROSS-LINKING? In April 2016, the FDA approved the corneal cross-linking procedure, which Dr. Gangadhar calls "one of the biggest advances in ophthalmology in a decade, maybe even longer." The minimally invasive procedure takes about 60–90 minutes and is done on an outpatient basis. In the procedure, the cornea's epithelium is removed and corneal tissue is soaked with riboflavin (vitamin B2) drops for 30 minutes. The corneal thickness is measured and then, for the remainder of the procedure, a UV light is shone onto the eye. The light treatment helps stiffen and strengthen the collagen fibers in the cornea. "With cross-linking, you're essentially creating molecular bonds, or cross-links, between those fibers and gluing them together. The procedure strengthens, stiffens and stabilizes the fibers," Dr. Gangadhar explains. If a patient requires the procedure in both eyes, as Zoey did, the second procedure is performed at least three months later. Most patients won't see an improvement in vision, but that's not the purpose of the procedure. " T he ma i n goa l of t h is is t o save v ision a nd avoid the need for a f uture cornea l tra nspla nt," Dr. Gangadhar says. FDA trial outcomes showed the procedure stops the progression of the condition for 92–95% of patients, and Grene Vision Group has had similar outcomes since it started offering the procedure in December 2016, Dr. Gangadhar says. Dr. Gangadhar has performed about 200 corneal cross-linking procedures, with more patients opting for the procedure as insurance reimbursement becomes more accessible, he says. In Europe, where the procedure was available for almost 10 years before FDA approval, studies indicate the rate of corneal transplant has dropped substantially in the past decade. Because the procedure is still new in the U.S., there is no similar data for U.S. patients. n Patients Should Have Annual Eye Exams and Report Vision Changes PATIENTS W ITH CH A NGE S in vision should always seek medical atten- tion. With annual eye exams that include measuring the cornea and computerized mapping of the eye's topography, a condition like kerato- conus can be diagnosed early. "If a child has problems on a school screening exam or if a patient reports eye problems to their family doctor, the patient should be sent to an optometrist or ophthalmolo- gist," says Dasa Gangadhar, MD, an experienced ophthalmologist with Wichita-based Grene Vision Group. "Maybe it's a normal refractive error like nearsightedness or farsighted- ness that can be corrected by lenses. But if vision isn't being corrected with that treatment, we have to look at other reasons for vision problems. One possibility can be keratoconus [when the cornea becomes misshapen]. There are subtle clues that the screening phy- sician, whether it's an optometrist or ophthalmologist, can look for, such as if the patient is not correctable to 20/20 vision or the patient has progressive nearsightedness with progressive astigmatism." The exact cause of keratoco- nus isn't known, but there is a genetic link, so it's important that patients know their family's eye health history. Also, keratoconus has been associated with eye allergies and eye rubbing, accord- ing to the American Academy of Ophthalmology. Grene Vision Group Covers All Eye Care, All Over Kansas With 36 optometrists and 11 ophthalmologists, Grene Vision Group is one of the largest eye care groups in the U.S. Grene Vision Group has 21 clinics in south-central and southeast Kansas and provides total eye care, including optical, primary, medical and surgical treatments in all ocular specialties for all ages. Several Grene Vision Group ophthalmologists also provide satellite medical and/or surgical services in 10 communities. For locations, visit grenevisiongroup.com. To refer patients, call 316-636-2010 or 800-788-3060. Dasa V. Gangadhar, MD, is a fellowship-trained corneal surgeon at Grene Vision Group. His areas of expertise include corneal cross-linking, corneal transplantation, and cataract and implant surgery. He has regularly handled the most complex medical and surgical cases from all over Kansas. 1 2

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