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465 N. Roxbury Dr. Suite 902, Beverly Hills, CA. 90210
Phone: 310.594.5209

Beverly Hills Keratoconus Specialist
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Holcomb C3-R®- Proprietary, Non-Surgical Corneal Crosslinking
 

On April 9, 2010 when Olympic Gold Medalist Bobsledder Steve Holcomb and Dr. Brian were on Dr. Phil’s The Doctors television show, Dr. Brian announced that the name   “C3-R” will be changed to “Holcomb C3-R” in honor of Steve Holcomb.  This marked the first time in history that a treatment for a disease was named after the athlete who made the treatment world-famous. Click here to watch the naming of Holcomb C3-R on The Doctors.

 

Keratoconus is more common now than ever before.  Once thought to occur in 1 in 2000 people, it is now 1 in 500 people (400% more common than in the past).

Dr. Brian is considered the "Guru of Modern Crosslinking." People regularly come from all over the United States, Canada, and other countries for his treatments.  He invented non--surgical Holcomb C3-R® (corneal collagen cross-linking riboflavin) that can strengthen the weak corneal structure in keratoconus. (see publications/ research section in right column).




This method works by increasing collagen cross-linking, which are most of the natural "anchors" within the cornea. These anchors are largely responsible for preventing the cornea from bulging out and becoming steep and irregular (which is the cause of keratoconus).

Listen to Dr. Howard's story of keratoconus.



Listen to Norris' experience 3 years after treatment.



 

The figures above show the parallel corneal layers (white) and the collagen cross-linking (red) which are typically increased after Holcomb C3-R® treatment.

 

Dr. Brian invented the Holcomb C3-R® - a non-invasive 30-minute, in-office procedure to better and safer for people than CXL which requires disruption of the epithelium. During Holcomb C3-R®, our proprietary Crosslinking Solution (containing riboflavin and other compounds) is applied to the cornea, which is then activated by a special light.

Invented in 2002, Holcomb C3-R® has the longest track record of all crosslinking techniques in the United States, Canada, Latin America & South America, Asia, and Europe (with the exception of Germany).   With Holcomb C3-R®, you know you are getting “the real thing” developed by modern crosslinking guru, Dr. Brian.

Dr. Brian developed a unique system that allows both eyes to be treated at the same time.  You won't have to come back on another day for the second eye to be treated which people find to be very inconvenient.

Holcomb C3-R® is special and proprietary - it is only available at our office - it is not available anywhere else.

Removing the epithelium (as done with CXL) creates a painful recovery and significantly increases risk of infection, corneal haze, scarring, and corneal nerve trauma requiring 6  months to recover.  The non-invasive Holcomb C3-R® allows patients to return to their normal routine the very next day!

Our studies and studies of other eye doctors in outside countries have shown patient results are not signficantly different with crosslinking with removal of epithelium vs. leaving epithelium undisturbed in its place.  Therefore, it is not necessary to scrape off the epithelium for crosslinking and is safer without scraping off epithelium. Please visit www.KeratoconusInserts.com for more information on results of Holcomb C3-R® vs epi-off (CXL) corneal crosslinking. 

 

Holcomb C3-R® treatments can also be combined with Intacs to help flatten the keratoconus cone even more than with Intacs alone - a technique also pioneered by Dr. Brian.  In these cases, Holcomb C3-R® treatments helped stabilize keratoconus from getting worse as well the Intacs helping in part to reverse the keratoconus steepening that had already occurred up to the time of the treatment.

 

The figure above demonstrates almost 10 diopters of corneal flattening in one patient before (left) after this Holcomb C3-R + Intacs treatments (right).

 

Holcomb C3-R® is also helping patients after radial keratotomy by improving stability and reducing vision fluctuations during the day.  Please click here for further information about how RK patients can be helped.  www.keratoconusinserts.com/RK. 

 

RIGHT EYE
   
LEFT EYE
   
Natural progression of keratoconus in a patient’s eyes over 1.5 years.  Notice the dramatic lower cone steepening (red) and increased astigmatism over this short period of time.  Holcomb C3-R® can halt this progression and prevent these progressive distortions in vision.  Note:  not all keratoconus progresses this rapidly.

 

In 2002, Dr. Brian was the first doctor in North America to use corneal collagen crosslinking for Keratoconus (now called Holcomb C3-R®) as well as being the first doctor in the world to combine corneal collagen crosslinking with Intacs. 

After Dr. Brian pioneered corneal collagen crosslinking, he was the first doctor in the world to present crosslinking results at a scientific meeting. There were many "doubter doctors" in the beginning - one doctor even told Dr. Brian that it's impossible for corneal collagen crosslinking to work.  Following Dr. Brian's numerous presentations, doctors in other countries finally began to take notice and started looking at the procedure for their Keratoconus patients.   Thankfully due to Dr. Brian's dedication and hard work, this procedure is now commonplace in many doctors practices around the world.

Dr. Brian has been performing collagen crossllinking for over 8 years - Dr. Brian has the LONGEST experience in corneal collagen crosslinking in the United States, Canada, and all other countries (except for Germany).  Would you trust your precious eyes to someone who just learned how to do the procedure?

Dr. Brian "wrote the book" on Keratoconus - "Modern Management of Keratoconus" which has now been translated into Spanish for all the Latin American countries.  This book is used for teaching eye doctors around the world about the latest advancements in crosslinking and other Keratoconus treatments.


For more extensive and detailed background information on Holcomb C3-R®, including research studies, please click on www.KeratoconusInserts.com.

CHART REVIEW AND CONSULTATION FOR OUT-OF-TOWN PATIENTS

Many out-of-town patients would like Dr. Brian to do a complimentary review of their medical records and make a preliminary determination of candidacy. This is useful before planning a trip to Beverly Hills. These are the steps:

  • Along with your last 2 or 3 eye exams, please be sure to include a color copy of your corneal mapping. Color corneal mapping is a very important tool, along with your exam history, to determine your candidacy. The last 2 years of your total eye history will be used to make this preliminary determination.

  • Inside the envelope, please be sure to include a cover sheet with your name address, phone number and email address and the words, “Keratoconus Record Review”, so that we may optimize communication with you.

  • Enclose with your letter a copy of your records.

    Mail to:
    Boxer Wachler Vision Institute

           Keratoconus Record Review
           465 N. Roxbury Drive, Suite 902
           Beverly Hills, CA 90210

           Or, you can scan your records and email to jen@boxerwachler.com.


           Dr. Brian will contact you to discuss the review.

           If you have any questions, please call us at 310-860-1900.

_________________________________________________________________

2010 Vision Awards

Dr. Brian and Steve Holcomb were honored at the 2010 Vision Awards for their historic accomplishments that led to a Gold Medal at the 2010 Winter Olympics in Vancouver.  Dr. Brian received the Jules Stein Living Tribute Award and Steve received the Athlete of Vision Award.  Many celebrities were on hand including Will.i.am of the Black Eyed Peas, astronaut Buzz Aldrin, comedienne Lilly Tomlin, cosmetic dentist Dr. Bill Dorfman, and actor Billy Bob Thornton among many others.

 

 
 
 
 
Dr. Brian speaking
 
Steve Holcomb at the podium
 
 
 
 
 
Dr. Brian before the press
 
Steve Holcomb with his gold medal and plaque
 
 
 
   
 
 
Buzz Aldrin
Dr. Bill Dorfman
 
Dr. Brian & Steve
Will.i.am
 

 

 

 





How Holcomb C3-R Was Developed

The first 1998 publication of crosslinking was with epithelium removal and it showed ability to stabilize the disease, but it reported pain in recovery and corneal swelling side effects (future studies would show many more side effects from epithelium-removal crosslinking such as corneal ulcers, cornea haze, very slow recovery, partial loss of vision, etc). Nonetheless after this publication, there was one peculiar thing: no one was performing crosslinking. The publication was out there, but went largely unnoticed by the ophthalmology community and medical societies. It was the equivalent of a "silent shot in the dark." Not one doctor around the world seemed to notice this publication in 1998, except one doctor: myself.

I was fascinated when I read this study as I was already was pioneering the use of Intacs® for Keratoconus as an alternative to invasive corneal transplants that carry significant risks. After my own research into crosslinking, I quickly realized that scaping off the epithelium will cause a lot of pain during the recovery and other potential problems. I thought, "there MUST be a better way!"

I worked to develop a way to perform crosslinking WITHOUT needing to do the invasive step of scraping off the cornea's epithelium top layer . After many, many nights working on this after hours, I finally discovered a method to obtain successful results. Was it possible to have a completely non-invasive procedure that stops Keratoconus in its tracks without the risks that epithelium removal crosslinking inherently carries? The answer was a resounding "YES!" After this discovery, I could hardly sleep that night.

I remember very vividly our first patient in January of 2003. He is a very famous movie producer in Hollywood (due to patient privacy, I cannot mention his name, but you would know his movies and the A-list stars of those movies), He unfortunately had Keratoconus develop after LASIK. I explained the nature of this new procedure that I invented. (I hadn't given it a name then). He was open to it and trusted me. The results were incredible: we stopped his Keratoconus from progressing and he was very happy. And best of all: he was back at the work the very next day after the procedure, no discomfort, no time off work, no change in his life. It was amazing, just a one day recovery.

I discussed with my wife Selina my excitement. On a plane flight with Selina shortly afterwards, I explained the nature of the procedure and that it needed to have a simple name. It would be hard for people to say: riboflavin in the cornea for collagen crosslinking. A lot of great ideas have been written on the back of a napkin. I suppose we can add the naming of this procedure to that list. Years ago I learned an process to help with creativity. You draw the words of interest in a circle and then keep looking at the words. Usually with time the solution will hit you. On the back of a United Airlines napkin I did this with Selina at my side.

Suddenly, the name of the procedure jumped out like a jack-in-box from the circle of words: C3-R®. There were three words with letter "C" (corneal collagen crosslinking) and one word with "R" (riboflavin). Eventually I obtained a United States Trademark for C3-R®. Since the C3-R® procedure is distinctly different from invasive epithelium removal crosslinking and other "home grown" epithelium-on crosslinking that some other doctors are trying to do now, I wanted to be sure we protected our established crosslinking C3-R® brand.

By doing this, the proprietary C3-R® procedure could never be confused with less desirable or unproven crosslinking techniques. C3-R® now has over 8 years behind it. People know and trust
C3-R® since it has stood the test of time and has an Olympic Gold medal behind it.

It's like with Coke® that is a protected brand owned by The Coca-Cola Company. When you buy a Coke®, you know exactly what you're getting. You know it won't taste different from what you expect. You know Coke® is made from the secret formula locked in a vault somewhere deep in The Coca-Cola Company headquarters in Atlanta, Georgia. You know if you buy a Coke, it's not a cheap knockoff from another company they call "Coke" because The Coca-Cola Company owns the trademark for Coke. These are all the same reasons that C3-R® is trademarked (and yes, our secret formula is also locked in a vault). People know with C3-R® they are getting the "real thing."

In 2007, our Keratoconus patient Steve Holcomb, the top bobsled driver for the United States Olympic team, regained 20/20 vision from C3-R® and Visian ICL and came back from vision-related retirement. He won Olympic Gold at the 2010 Winter Olympics in Vancouver, the first Olympic Gold for the U.S. in 62 years. On April 9, 2010 when Steve and I were on Dr. Phil's The Doctors television show, I announced the name modification of "C3-R®" to "Holcomb C3-R®" in honor of Steve Holcomb. This marked the first time in history that a treatment for a disease was named after an Olympic athlete who made the treatment world-famous. Because of the massive media exposure about Steve's Olympic accomplishment and his comeback from Keratoconus, people around the world now know there are options besides invasive and painful cornea transplants.

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Receive a FREE Copy of Dr. Brian's New Keratoconus Book!
 

Dr. Brian is a published author and his third Keratoconus book, "HOW WE CONQUERED KERATOCONUS" will be released soon.

Only the first 37 people to request a copy will receive the book for free. Please click the button below to claim your copy:

 
 
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LOOK WHO CAN SEE FOR
"MILES AND MILES"
Keratoconic Bobsled Driver Holcomb Sees Better Things Ahead

 

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PUBLICATIONS/RESEARCH

Study Reveals - Epithelium Removal for Crosslinking is Not Necessary
Ophthalmologists have debated whether epithelium removal is necessary for crosslinking. Dr. Boxer Wachler pioneered the Epithelium-On technique and this study shows that epithelium-on is effective.

The Vision to Win: The Surgical Secret of a Bobsled Champ's Success
Article in Popular Science about how Holcomb C3-R and Visian ICL allowed Olympic Bobsledder Steven Holcomb overcome Keratoconus. March 2009.

Bobsled Driver Holcomb Sees Better Things Ahead
USA Today article about how Dr. Boxer Wachler cured Olympic Bobsledder Steven Holcomb from Keratoconus.  October 2008.

Holcomb C3-R Treatment Opens New Frontiers for Keratoconus and Corneal Ectasia
Roberto Pinelli, MD. Eyeworld 2007, 34-36.

Safety of Holcomb C3-R special light at the Retinal Level and Compared to Outdoor special light Exposure
Leonard Yuen, MD and Brian S. Boxer Wachler, MD

No Progression of Keratoconus 5 Years after Holcomb C3-R
Wollensak G. Crosslinking treatment of progressive keratoconus: new hope. Curr Opin Ophthalmol. 2006 Aug;17:356-60.

Safety of special light-Riboflavin Cross-Linking of the Cornea
Eberhard Spoerl, PhD, Michael Mrochen, PhD, David Sliney PhD,
Stephen Trokel, MD, Theo Seiler, MD, PhD, Cornea 2007; 26:385-389

The Effect of Inferior Segment Intacs with and without Corneal Collagen Crosslinking with Riboflavin (Holcomb C3-R) on Keratoconus

Colin C.K. Chan, MD, FRANZCO, Munish Sharma, MD, Brian S. Boxer Wachler MD, J Cataract Refract Surg 2007;33:75-80

Comparison of Single Segment and Double Segment Intacs for Keratoconus and post-LASIK Ectasia

Munish Sharma, MD, Brian S. Boxer Wachler, MD, Amer J Ophthal 2006;141:891-895

Woman with Progressive Keratectasia after LASIK Treated with Holcomb C3-R® and Wavefront LASEK. Colin CK Chan, MD, Brian S. Boxer Wachler, MD.  Ocular Surgery News 2005 Aprill

Holcomb C3-R® (corneal collagen crosslinking with riboflavin) increases Effect (lower L-U Ratio) of Single Segment Intacs in post-LASIK Ectasia and Keratoconus
Presented at the American Academy of Ophthalmology Annual Meeting, 2005

Holcomb C3-R® (corneal collagen crosslinking with riboflavin) for Corneal Stabilization
Presented at the American Academy of Ophthalmology Annual Meeting, 2005

Corneal Collagen Crosslinking with Riboflavin.  A New Treatment to Strengthen the Cornea for Keratoectasia and Keratoconus. Brian S. Boxer Wachler, MD, Cataract and Refractive Surgery Today 2005 January, 73-4.

Collagen Fiber Diameter in the Rabbit Cornea After Collagen Crosslinking by Riboflavin/special light Gregor Wollensak, MD et al. Cornea. 2004 Jul;23(5):503-507.

Stress-strain measurements of human and porcine corneas after riboflavin-special light-induced cross-linking
Gregor Wollensak, MD et al. J Cataract Refract Surg. 2003 Sep;29(9):1780-5.

Riboflavin/special light-induced collagen crosslinking for the treatment of keratoconus
Gregor Wollensak, MD et al. Am J Ophthalmol. 2003 May;135(5):620-7


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