Optical Aberation after CXL

[Ionel]

Hello I had cross linking 8 months ago and I have a Question regarding Optical Aberation that appear at one light source . These optical aberation has changes continously after CXL . Is it normal ? Is this a sign that CXl does not stop the KC?

[longhoc]

Hi Ionel...

... and a big "Welcome" to the Forum !

Just a quick question if I may, when you say "Optical Aberation" do you mean what's commonly described as "ghosting" -- the halo effect or "starburst" that appears around point sources of light ? There's a good picture mock-up of this symptom at the US Keratconus support site http://www.nkcf.org/en/about-keratoconu ... ptoms.html (see picture on the right hand side).

Is this what's affecting your vision now ?

Best wishes

Chris

[Ionel]

Hi I mean "starburst" that appears around point sources of light and These starburst affect my vision.
Is this a sign that CXl does not stop the KC?

[longhoc]

Hi there Ionel

Okay, thanks, your answer helps a lot.

The continued (or more noticable than before) distortions in your vision which you are experiencing does not mean the Crosslinking hasn't worked. But what is important is to ensure that whoever performed the procedure gives you good follow up aftercare. You'll need to have regular scans of your cornea done to confirm that progression of your Keratoconus has indeed been halted. This will take a while as your cornea will continue to heal following the procedure (I'm assuming you had the "epi-off" version of Crosslinking).

But -- the Crosslinking will not in and of itself do that much necessarily to improve the shape of your cornea. It might, but that is definitely a bonus and not something that you can rely on happening. This is why you might well not have ended up resolving the visual distortion around point sources of light (amongst other effects).

What you will have is a (hopefully) stable cornea that might respond to other interventions such as Intacs, implantable contact lenses, laser reshaping of the cornea and so on. Or you might just find that contact lenses are okay. Talk to the clinic who did your Crosslinking about what they think best in terms of getting your vision in a state that you are happy with -- they should be able to explore the various options with you.

Let us know if you need any more information at all.

Best wishes

Chris

[NickDash]

Optical aberrations will fluctuate after Cross-Linking as the cornea continues to stabalise. We know that improvements in stability continue for the first 3 years. (In some cases it might get worse immediately after surgery before getting better.
Corneal cross linking will not eliminate all aberrations, in-fact C3R alone is anticipated to stop the keratoconus from deteriorating. Reduction in aberrations may occur in some cases over the period of 3 years, but this is only 'icing on the cake'. Cross linking is a method of stopping things getting worse.
In some cases, where appropriate, corneal remodeling can be undertaken using a laser (TCAT and cross linking) or indeed Intacts might offer some improvements. But it is not realistic to expect elimination of the distortions. Wearing of rigid contact lenses may offer the best visual quality in any keratoconic cornea or to a lesser extent Custom Soft Lenses such as the Kerasoft IC.