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Fitting Contacts for Cross-Linking Patients Post-Procedure

Person putting in contacts.

For physicians treating progressive keratoconus, performing iLink, the only FDA-approved cross-linking procedure, is just one of the steps towards getting patients on the right path to managing their condition. Another is fitting them with the right contact lenses.

At the 2019 Optometry’s Meeting in Saint Louis, Dr. Clark Chang, OD, MSA, of Wills Eye Hospital in Pennsylvania and Glaukos Medical Affairs spoke with Healio news and shared some tips for providing post cross-linking patients with the right contacts.

Dr. Clark Chang.

Post-Procedure Wait Time

First and foremost, Dr. Clark Chang says patience is key in deciding when you should begin fitting cross-linking patients with contact lenses. Waiting for the epithelium to fully heal following an epi-off cross-linking procedure is best practice, even if it means waiting anywhere between 4 to 6 weeks.

While piggyback, hybrid, or scleral lenses may be fitted soon after the procedure, it may be worth waiting longer to try soft or corneal gas permeable (GP) lenses, which can be more comfortable and potentially more cost-effective for the patient.

Contact Lens Comfortability

For patients that require easy lens handling, corneal GP and soft lenses may be best because they are typically easier to insert and remove. However, if comfort is their top priority, then the patient may be better suited for hybrid or scleral lenses.

Above all, Dr. Chang emphasizes that one size does not fit all patients when it comes to contact lenses. While corneal GP lenses remain the gold standard, lenses that work for one patient may not be suitable for another.

Click here to watch the full video with Dr. Chang on Healio.

Using Photrexa® Viscous (riboflavin 5’-phosphate in 20% dextran ophthalmic solution), Photrexa® (riboflavin 5’-phosphate ophthalmic solution), and the KXL® System, the iLink™ corneal cross-linking procedure from Glaukos is the only FDA-approved therapeutic treatment for patients with progressive keratoconus and corneal ectasia following refractive surgery.*1

[Photrexa IFU/p1/col1/para3/lines1-4]

Indications

Photrexa® Viscous (riboflavin 5’-phosphate in 20% dextran ophthalmic solution) and Photrexa® (riboflavin 5’-phosphate ophthalmic solution) are indicated for use with the KXL System in corneal collagen cross-linking for the treatment of progressive keratoconus and corneal ectasia following refractive surgery.

Important Safety Information

Corneal collagen cross-linking should not be performed on pregnant women.

Ulcerative keratitis can occur. Patients should be monitored for resolution of epethelial defects. The most common ocular adverse reaction was corneal opacity (haze). Other ocular side effects include punctate keratitis, corneal striae, dry eye, corneal epithelium defect, eye pain, light sensitivity, reduced visual acuity, and blurred vision.

These are not all the side effects of the corneal collagen cross-linking treatment. For more information, go www.livingwithkeratoconus.com to obtain the FDA-approved product labeling.

You are encouraged to report all side effects to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

*Photrexa® Viscous and Photrexa® are manufactured for Avedro. The KXL® System is manufactured by Avedro. Avedro is a wholly owned subsidiary of Glaukos Corporation.

Reference

1. Photrexa [package insert]. Waltham, MA: Glaukos, Inc. 2016