Foulkes Vision Becomes First Ophthalmology Practice in Illinois to Adopt Corneal Cross-Linking for Ecstasia

    LOMBARD, IL, January 24, 2017 /24-7PressRelease/ -- Foulkes Vision announced on Friday that it is the first Illinois eye center to offer a treatment for weak corneal conditions called ectasia through the use of a procedure recently approved by the FDA called corneal cross-linking. Dr. Richard Foulkes, who is an anterior segment surgeon, works with the inventor of the technique in Switzerland, Dr. Theo Silar.

Background

Dr. Silar performed the first human treatments in 2003. Tens of thousands of patients around the world have benefited from cross-linking since that time.

"Cross-linking is the standard of care throughout the world for corneas that have weakened and are thinning from the most common cause - a condition called keratoconus," Dr. Foulkes said. "This is a proven treatment, and in most cases can prevent and reverse progression, which in some cases can lead to a corneal transplant."

Though the delay in approval left many Americans to advance with their disease over the past decade, Dr. Foulkes said that the wait did provide the opportunity to follow the long-term effects of corneal cross-linking.

"Dr. Silar has shown that once this treatment is applied that the cornea begins to reverse the steepening that leads to severe astigmatism and significant loss of vision," he said. "Only this approved technique has been studied long enough to show its long-term efficacy."

Details of Corneal Cross-Linking

Dr. Foulkes recently discussed corneal cross-linking during an interview on the eHealth Radio Network. The procedure involves removing a thin layer from the front of the clear tissue on the front of the eye (the cornea). The cornea is then soaked with riboflavin for 30 minutes.

"In patients with keratoconus, the eyes are progressively thinning," Dr. Foulkes said, "to protect the inner layer of cells in the cornea, we need to have 400um of cornea left."

To achieve this, he said, delay should be avoided.

"There is a significant need for patients who have this condition to understand that they need to have this treatment done sooner rather than later when they may be beyond the point where we can safely apply this eye-saving procedure," Dr. Foulkes said.

Once the eye is fully soaked in the B vitamin, a 3 mW ultraviolet light is applied to the eye in short intervals to activate the riboflavin.

"The UV causes the riboflavin to release singlet oxygen, which is called a free radical," Dr. Foulkes said. "This in turn causes the front 150-200um of the cornea to fuse together like a basket weave, which stops and can reverse the bulging and thinning that was occurring."

Aftercare

The healing time is typically three to five days. The patient may have variable degrees of discomfort.

"As we are a refractive center," Dr. Foulkes said. "We are experienced at reducing discomfort during the healing phase."

The cornea will develop a thin layer of haziness that can be seen by the practitioner and is the evidence that the cornea is strengthened. The haze diminishes over a few months and is not often seen by the patient.

"The vision change is modest early on, but Dr. Silar has cautioned that as this process evolves the cornea will continue to improve for years," Dr. Foulkes said. "We therefore do not wish to over-correct in the initial phase."

Am I at Risk of Keratoconus?

Keratoconus often can be seen in teenagers. The sooner the treatment can be applied, the better the effect.

Currently insurance companies have not come online to pay for the procedure despite its proven effectiveness and reduction in lifetime cost that will be associated in avoiding a corneal transplant.

"The fee is now modest and can be financed, so we do not recommend delaying treatment," Dr. Foulkes said. "When possible, we combine cross-linking with an insurance-supported technique of adding a corneal support call INTAC. The improvement in vision is seen more rapidly if we can combine these technologies."

ABOUT FOULKES VISION

Richard B. Foulkes, M.D., lectures worldwide on a host of ophthalmology subjects. He has been part of the development of many technologies and holds patents in his field. At Foulkes Vision, he performs LASIK vision correction, cataract surgery and other eye care procedures for patients throughout the Chicago area.

Dr. Foulkes has no financial interest in Avedro, the company that won approval for cross-linking in the United States.

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