The CLEI Center for Keratoconus was created in 2002 as a center of excellence dedicated to the care of the keratoconus patient. Offering the entire range of advanced keratoconus treatment, CLEI also is working to advance KC care in the future.
Dr. Hersh is the founder and director of The Cornea and Laser Eye Institute – Hersh Vision Group. He is a graduate of Princeton University, Johns Hopkins Medical School, and the Harvard Medical School ophthalmology residency and corneal surgery fellowship programs.
Dr. Hersh’s interests are exclusively devoted to cornea and refractive surgery. In recent years, he has been Principal Investigator for numerous Corneal Collagen Crosslinking (CXL) FDA clinical trials, exclusively for patients with keratoconus or corneal ectasia. He is currently the medical monitor for Avedro, Inc, a company dedicated to advancing crosslinking science and treatment of the keratoconus patient.
Our goal on our website, www.keratoconuscenter.com,is to give the keratoconus patients the latest complete knowledge of keratoconus management, procedures, and new scientific and treatment advances.
A number of surgical options are available to the keratoconus patient. Since keratoconus can vary widely from patient to patient, the proper recommendation of any of these procedures depends on the individual nature of your problem.
To find out if you are a candidate for any of the techniques described below, please call our office at 201-883-0505 or e-mail, firstname.lastname@example.org, and we can schedule our thorough 3 hour keratoconus initial evaluation with Dr. Hersh and our experienced staff. At the end of your exam, you will meet with Dr. Hersh and, together, can discuss treatment plans, whether it be one of the treatments below, specialty keratoconus contact lenses, or a combination to formulate the right strategy to maximize your vision and future wth keratoconus.
Keratoconus treatment options include:
Intacs: Intacs are implantable intracorneal ring segments (ICRS). You can visualize it If you picture a contact lens, punch a hole through it to make it a doughnut, and then cut it in half. The goal of Intacs is to reshape the cornea in keratoconus in order to make it more regular and, optically, smoother. The clinical benefit varies with your problem. Intacs can help to make contact lens wear easier with better results, improve vision with glasses by decresing the “visual static” caused by the irregular keratonus cornea, and improve general vision in some patients.
The size and position of the Intacs segments are chosen based on your individual corneal shape. One or two segments are placed depending on the individual measurments. The Intacs procedure is performed at the Cornea and Laser Eye Institute – CLEI Center for Keratoconus using numbing drops for comfort. The first step uses a special laser, called a femtosecond laser, to create a tract or tunnel within the cornea in which to place the Intacs. Segments are then placed in the proper position within the tunnel. Usually, sutures are not necessary and you will use drops for 1-2 weeks.
Typically, patients may return to work one day after the procedure.
Conductive keratoplasty uses localized spots of radiofrequency energy on your cornea to reshape the corneal optical contour. In keratoconus, we often use CK to enhance the astigmatism-reducing effect of Intacs.
Corneal collagen crosslinking (CXL) is a relatively new procedure to treat keratoconus. Crosslinking is not U.S. FDA approved, and can only be done in the U.S. under the auspices of registered clinical trials under regulatory oversight. Currently, at the CLEI Center for Keraotoconus, we are accepting patients into a number of clinical trials of crosslinking. The goal of CXL is to decrease the progression of keratoconus, a disease where corneal distortion worsens over the years. Crosslinking utilizes riboflavin drops (Vitamin B2) and ultraviolet light which interact with the corneal tissue to create “crosslinks” between corneal proteins. This strengthens the cornea, which is weak in keratoconus, with the goal of decreasing KC progression.
Corneal transplant techniques for keratoconus have evolved over the last several years. In many case, here at the CLEI Center fo Keratoconus, we perform laser-assisted transplants. These use a femtosecond laser to perform preparation of both the patient cornea and the donor cornea. This allows a meticulous match of the graft and host, with the goal of a more dependable healing process and a smoother corneal contour after surgery. Patterns such as zig-zag and mushroom configurations can be used depending on the shape of the keratoconus cornea to be treated.
Excimer Laser PTK
Excimer Laser PTK and superficial keratectomy (SK): Smoothing procedures can be used to treat corneal nodules, which may develop in keratoconus and to decrease corneal scarring in some cases.