Keratoconus Treatments

A diagnosis of Keratoconus can be frightening. If you have family history of Keratoconus then you may have already experienced the devastating effects it can have on daily life. Today however, technology has allowed for several new Keratoconus treatments that can slow the progression of Keratoconus or even in most cases stop the progression.

Blurred vision due to KeratoconusSymptoms of Keratoconus Include

  • Blurred vision
  • Frequent prescription changes
  • Halos
  • Difficulty with night vision
  • Excessive rubbing of the eyes
  • Double Vision
  • Headache

In the past most patients with Keratoconus were told their only inevitable treatment option would be a Corneal Transplant, but since 1999 many other revolutionary Keratoconus treatments have allowed for faster recovery times and improved vision.

Today’s Keratoconus Treatments

13 Years of Holcomb C3-RHolcomb C3-R® or Corneal Collagen Cross-linking with Riboflavin. This revolutionary treatment developed in 2003 by Dr. Brian Boxer Wachler is used to preserve the vision of those suffering with Keratoconus by using a more natural approach. A vitamin rich solution is applied to the eyes and then activated with a special UV light. This procedure helps strengthen the cornea and stop the progression vision loss from Keratoconus by rebuilding the weaken collagen. This procedure helps to preserve a patient’s current vision. When combined with other procedures, such as INTACS®, overall vision can be improved.


This procedure consists of tiny inserts placed in the layers of the cornea to improve your natural corneal curve. Originally Intacs® were developed to treat mild nearsightedness. However, in 1999 Dr. Brian discovered that as a Keratoconus treatment, patients with Keratoconus have been able to avoid a cornea transplant and have improved quality of vision with this minimally invasive option. Intacs® reshape the damaged irregular shape of the patient’s cornea providing them with more stability, and clearer vision. Intacs® has also been combined with Holcomb C3-R® (Corneal Collagen Cross-linking with Riboflavin) since 2003 to strengthen the cornea, provide further improved vision, and stabilize the Keratoconus. Intacs® and Holcomb C3-R® can be performed within the same day, minimizing downtime for those seeking the most advanced Keratoconus treatments.

Below are some benefits of Intacs®:

  • 10 minute procedure
  • Procedure is performed in the doctor’s office small procedure room
  • Minimally invasive, unlike months of recovery with a cornea transplant
  • Minimal recovery time, back to normal activities in a few days
  • Minimal to no pain, unlike the painful cornea transplant

Intacs® and Holcomb C3-R® offer a great treatment plan for patients suffering from Keratoconus. In the past treatments only consisted of hard contact lens until they became too painful and then a patient would undergo the painful and invasive corneal transplant. Understanding that there are new and improved Keratoconus treatments that can help, provide hope and peace of mind.

Other Keratoconus Treatments:


Short for Conductive Keratoplasty, this procedure is designed to help reduce astigmatism. When combined with Holcomb C3-R® Crosslinking System, the CK treatment can effectively reduce astigmatism for a period of several years. Due to the nature of the cornea in Keratoconus patients, the effect of CK can diminish with time. The addition of Holcomb C3-R® greatly improves the longevity of the CK procedure. However, if needed patients may elect to have future CK treatments to reduce astigmatism.

Implantable Contact Lens


ICL, short for Implantable Contact lens, reduces overall prescription and in some cases can greatly reduce the need for contacts or glasses. Once the cornea has been stabilized with a combination of Holcomb C3-R® Crosslinking System and/or Intacs® and/or CK, a patient can consider the ICL procedure. Typically this is performed 3-6 months after the cornea stabilization procedures.

ICL is known most for its simplicity, safety, and removability. The ICL is designed to stay in the eye for a lifetime, and does not require any maintenance. Because it does not significantly alter any structures within the eye, it is very safe and can be easily removed if necessary or desired by the patient in the future.


Photorefractive keratectomy (PRK) is a laser eye procedure which reduces a patient’s prescription. Although this procedure is performed with a laser, it is different than LASIK. PRK can be a safe treatment option for Keratoconus patients. Also, this can be an option for patients who previously underwent a cornea transplant and have high residual astigmatism. PRK can reduce the need for contact lenses and/or glasses.

Keratoconus contact lenses

Contact Lenses

It has long been thought that the use of RGP hard contact lenses slowed the progression of Keratoconus. We now have come to understand that this it is a myth that contacts slow progression. However, once your Keratoconus has been stabilized with Holcomb C3-R® Crosslinking, contact lenses can be a great option to achieve your best corrected vision.

These days there are many options advanced contact lens designs and options for Keratoconus patients, including Scleral, Hybrid, RGP, and Soft Toric. These Keratoconus contact lens designs can achieve great vision results and improved comfort after Keratoconus has been stabilized.

Corneal Transplant eye-patch

Corneal Transplantation

A corneal transplant involves the removal of the central portion of the diseased cornea and replacing it with a donor, cadaver cornea. The donor cornea is held in position with fine sutures or stitches. The healing process that follows can take a year or longer. It is common to experience large amounts of astigmatism or irregular astigmatism which require correction with RGP contact lenses. This defeats the purpose of having the transplant. Some patients may be a candidate for PRK after 1 year. Cornea transplant surgery is very invasive and carries significant risks such as graft rejection, cataract, infection, and retina detachment.

The “dirty little secret” about cornea transplants is that the cornea is NEVER as strong as a cornea without a transplant. Unfortunately, most transplant surgeons will not tell patients about this risk. After a transplant, even a little bump or hit to the eye can rip open the edges of the cornea and delicate internal structures can come out (eg iris, natural lens, and retina) and cause permanent blindness and can even cause loss of the eye itself.

Fortunately, Dr. Brian’s Holcomb C3-R® and Intacs can prevent the need for a cornea transplant in the future. Many patients are elated and RELIEVED to have this “peace of mind.”

Keratoconus treatments can stop the progression and improve your overall quality of vision. The earlier it is caught and treated, the better your visual outcome.

Here are a few reasons to get early treatment for Keratoconus:

  • Early Detection can improve outcomes of treatment
  • Early Detection can slow the progression of Keratoconus
  • Early Detection can preserve vision
  • Early Detection can require less treatments to stabilize and improve vision


Ian discusses how revolutionary Keratoconus treatments have improved his life and vision


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.

Some people’s friends ask them, “Why are you thinking of travelling to Beverly Hills for your eye procedure?” They typically answer with, “I deserve the BEST and I want to go to the BEST doctor!”

These are the three easy steps for your complimentary chart review with Dr. Brian:

  • 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 them to

Dr. Brian’s Keratoconus Specialist will contact you to discuss the review.

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