Is a Corneal Transplant Necessary for Keratoconus These Days?

Keratoconus Beverly Hills

Dr. Brian Boxer Wachler is an accomplished ophthalmologist who completed a specialty fellowship in corneal transplant surgery. Despite his cornea transplant experience, he is pleased to report to his keratoconus patients that he does not need to put this skill to use nearly as often as he may have anticipated while undergoing his training. His advancements in keratoconus treatment have made corneal transplants much rarer. Continue reading to find out why that is true.

What Is Corneal Transplant?

Corneal transplant, also known as keratoplasty, is a surgery that removes some of the corneal tissue and replaces it with cadaver donor tissue from an organ/tissue bank. As the stitches dissolve, the new tissue merges with the existing corneal tissue to create a healthier, functioning cornea.

Although a corneal transplant is effective at replacing diseased tissue for most patients, it is a serious surgery with a lengthy recovery. There is also a risk that the body rejects the donor tissue over the course of one’s lifetime. The “dirty little secret” about cornea transplants for keratoconus – the surgeon has no way of predicting the prescription and as a result there often is very high amounts of astigmatism afterwards – sometimes higher than original astigmatism with the keratoconus prior to transplant.

In addition to keratoconus, corneal transplant may be performed to address several issues, including corneal scarring, corneal swelling, and corneal ulcers.

History of Keratoconus Treatment

When corneal transplant was first introduced at the beginning of the 1900s, it was a welcome solution for keratoconus patients who wanted to regain their sight. Although contact lenses and scleral lenses could correct vision for many patients, these lenses could not stop the progression of keratoconus. For those whose eyeballs became so conical they could no longer wear lenses, surgery was the only option at that time.

A New Treatment Emerges

Fortunately, two decades ago, keratoconus treatment improved dramatically with the introduction of corneal cross-linking and Intacs 24 years ago – both pioneered by Brian Boxer Wachler, MD. Rather than attempting to mitigate the effects of keratoconus with a corneal transplant after it gets unbearable, non-invasive, 1-day recovery Holcomb C3-R (epi-on) corneal cross-linking can halt progression of keratoconus with a 99.3% success rate so that an invasive corneal transplant is not necessary.

Holcomb C3-R corneal cross-linking uses drops of riboflavin and special ultraviolet light to pause keratoconus progression. This non-invasive treatment is highly effective on almost all patients. Although corneal transplant can still be used to treat keratoconus, this surgery is often not necessary after Holcomb C3-R and Intacs.

Seek Treatment for Keratoconus

Dr. Brian is one of the world’s foremost experts in the study and treatment of keratoconus. Patients travel from around the country to undergo his signature Holcomb C3-R cross-linking (epi-on) to prevent their keratoconus from reaching advanced stages. He is also available for those patients who do warrant corneal transplant. To make an appointment at the Boxer Wachler Vision Institute, please call 1-310-860-1900.

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A BRIEF NOTE ABOUT DR. BRIAN

Throughout his highly respected career, cornea specialist Dr. Brian has never wavered with his integrity and dedication to always do the best for each and every patient - even in the face of adversity and peer pressure. Case in point: when he developed a procedure to treat a cornea condition known as Keratoconus. While other eye surgeons were entrenched in performing invasive and painful cornea transplants, Dr. Brian invented a new non-invasive procedure that prevented needing cornea transplants. He was shocked by the medical establishment being unwelcoming to his innovation because, as he later found out, his new procedure was preventing other eye surgeons from performing their lucrative cornea transplants. Dr. Brian persisted, went against the grain and didn’t give up because he believed in himself and in his procedure as it was in the best interest of patients. Eventually, he crossed paths with U.S. Olympic bobsled driver Steven Holcomb who had Keratoconus and became so depressed over it that he tried to commit suicide. Luckily, he survived. The United States Olympic team and his coaches found Dr. Brian and sent Steven to see him. Dr. Brian restored his vision to 20/20 which enabled Steven later win a historic Olympic gold medal for United States in bobsled - the first in 62 years! As a result, Dr. Brian was later invited to give a prestigious TEDx talk about his integrity and dedication to patients. You can watch his moving and inspiring TEDx talk here.

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