Keratoconus (also known as Pellucid) is a progressive non-inflammatory disorder that causes a characteristic thinning and cone-like steepening of the cornea. This steepening results in distortion of vision, increased sensitivity to glare and light and an associated reduction in visual acuity. These symptoms usually appear in the late teens and early twenties. 

Keratoconus may progress for 10-20 years and then can slow or even stabilize. Each eye can be affected differently. This can result in a dramatic decrease in the ability to see clearly even with corrective lenses.

(Note: as keratoconus and pellucid are the same disease process, any reference to “keratoconus” on this site also applies to “pellucid” as well.)  New research shows Keratoconus occurs in 1 in 500, here are some of the symptoms you may experience:


[box_title title=”KERATOCONUS SYMPTOMS” before_title=”BOXER WACHLER VISION INSTITUTE”][/box_title][section_analytics css_animation=”bounceIn” image=”6149″][section_analytics_option css_animation=”fadeInUp” title=”BLURRED VISION” under_title=”Blurry vision in one eye or both eyes may be a symptom of Keratoconus, along with squinting, eye strain and headaches.”][/section_analytics_option][section_analytics_option itempos_vert=”middle” css_animation=”fadeInUp” title=”DOUBLE VISION” under_title=”Double vision is the simultaneous perception of two images, usually overlapping, of a single scene or object. Which may also be a symptom of Keratoconus.”][/section_analytics_option][section_analytics_option itempos_vert=”bottom” css_animation=”fadeInUp” title=”POOR NIGHT VISION” under_title=”Poor night vision is a condition of Keratoconus that can cause night blindness, including: nearsightedness, or blurred vision when looking at faraway objects.”][/section_analytics_option][section_analytics_option itempos=”right” css_animation=”fadeInUp” title=”FREQUENT EYE RUBBING” under_title=”Frequent Eye Rubbing stimulates tears to flow, lubricating dry eyes and removing dust and other irritants that may be caused by Keratoconus.”][/section_analytics_option][section_analytics_option itempos=”right” itempos_vert=”middle” css_animation=”fadeInUp” title=”GLARES OVER LIGHTS/HALOS” under_title=”Halos are bright circles that surround a light source, like headlights. Glare is light that enters your eye and interferes with your vision.”][/section_analytics_option][section_analytics_option itempos=”right” itempos_vert=”bottom” css_animation=”fadeInUp” title=”FREQUENT PRESCRIPTION CHANGES” under_title=”Frequent Changes in Eyeglasses or Contact Lenses Prescriptions is a common condition of Keratoconus that causes a clouding of the eye’s natural lens.”][/section_analytics_option][/section_analytics]
[box_title title=”KERATOCONUS TREATMENTS” before_title=”BOXER WACHLER VISION INSTITUTE”][/box_title]

Cornea Cross-Linking HOLCOMB C3-R®

(corneal collagen cross-linking riboflavin). Can strengthen the weak corneal structure and prevent cornea transplants.

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Intacs are micro-thin prescription inserts. Which were previously used as a form of refractive surgery in the treatment?

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Conductive Keratoplasty (CK).  Is a noninvasive procedure which utilizes radiofrequency energy to improve astigmatism.

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Visian ICL is an implantable contact lens. That can correct moderate to severe myopia, or moderate to severe nearsightedness.

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[box_title before_title=”FLY IN FOR YOUR PROCEDURE” title=”IT’S AN EASY 3 DAY TRIP TO BEVERLY HILLS” after_title=”RECORDS REVIEW IN 6 EASY STEPS”][/box_title]
[box_feature_left_icon title=”1. Request a Copy of Your Exam” link=”|||” icon_pixstrokegap=”icon icon-Floppy”]Please request a copy of your most recent eye exam from your doctor. And be sure they include your manifest refraction (prescription) with best corrected.[/box_feature_left_icon][box_feature_left_icon title=”2. Request a copy of your Topography” link=”|||” icon_pixstrokegap=”icon icon-Files”]Also, request a copy of your most recent cornea map (topography) from your doctor.  Finally, please be sure the copies are clear and readable.[/box_feature_left_icon]
[box_feature_left_icon title=”3. Write A Cover” link=”|||” icon_pixstrokegap=”icon icon-Pencil”]Most noteworthy.  It is important to write a brief cover sheet explaining your current vision condition.  And describe what may be the causes or symptoms of your situation.[/box_feature_left_icon][box_feature_left_icon title=”4. Best Phone/Email” link=”|||” icon_pixstrokegap=”icon icon-Phone2″]Include on the cover sheet the best phone number and e-mail to contact you.[/box_feature_left_icon]
[box_feature_left_icon title=”5. Scan and Email” link=”|||” icon_pixstrokegap=”icon icon-FileBox”]Scan all of your documents and information. And then, please e-mail it to .[/box_feature_left_icon][box_feature_left_icon title=”6. Or Mail it Over” link=”|||” icon_pixstrokegap=”icon icon-Mail”]Finally, mail your records directly to. Boxer Wachler Vision Institute (Records Review). 465 N. Roxbury Drive, Suite 902, Beverly Hills, CA 90210[/box_feature_left_icon]
[box_icon_big title=”ARE YOU GOING BLIND FROM KERATOCONUS?” icon_pixstrokegap=”icon icon-Phone2″ css_animation=”fadeInLeft” info=”DON’T WAIT, GET HELP NOW! CALL: (310) 594-5210″]

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How Bobsledder Steven Holcomb Overcame Keratoconus to Win Olympic Gold

Are You Going Blind From Keratoconus?

If you answered yes, then please watch the video below:

Here are just a few facts of Holcomb C3-R® vs CXL (derived from published studies from Avedro on crosslinking approved in US):

holcomb c3-r vs cxl
Keratoconus got worse in a whopping 28.4% of people after SHORT follow up of just 1 year.

6 Reasons Why Holcomb C3-R is More Effective than CXL

  1. Progression rate for Holcomb C3-R is 0.7% since we have begun treatment in 2003
  2. In comparison, progression rate of CXL patients is 28.4% in just 12 months of the CXL clinical trials. It has 40x’s higher rate of progression than Holcomb C3-R!
  3. This means CXL has a 2,000% higher rate of progression than Holcomb C3-R!
  4. 26.5% of CXL patients lost vision at one month post operatively!
  5. Study focused more on epi-off, and did not publish data on rate of progression of epi-on. So if U.S surgeons are doing epi-on, this was not evaluated by the FDA. Therefore, the results are unknown, and certainly would not be better than epi-off CXL progression rate.
  6. Side effects of CXL: Ulcerative Keratitis, Corneal Haze, Punctate Keratitis, Epithelial Defect, Extreme Pain/Discomfort. Reduced Vision/Blurry Vision. Holcomb C3-R covers 157% more surface area than CXL and uses customizable energy levels (CXL’s are fixed)

Patients Explain that Dr. Brian’s Holcomb C3-R® was Significantly Easier (No Pain) with 1-Day Recovery vs. Very Painful and Long Recovery CXL

Watch Patients Describe Holcomb C3-R® 1-Day Recovery vs. Very Painful and Long Recovery Following CXL

Dr. Brian Boxer Wachler: Inventor of the First Non-Invasive Cornea Collagen Crosslinking, Holcomb C3-R® (Since 2003)

How to Treat Keratoconus without a Risky Cornea Transplant

  • Did your doctor tell you that your only option is a “cornea transplant“?
  • Does the thought of having a cornea transplant scare you?
  • Are you concerned about driving at night?
  • Do you feel hopeless and that there are no other options?
  • Are you experiencing glares or halos at night?
  • Have you ever felt depressed because of your vision?
  • Do you avoid going out at night?
  • Are you concerned you won’t pass the driver’s test at the DMV?
  • Did you go in for LASIK, but were surprised to find out you have Keratoconus?
  • Has your doctor NOT told you about other options such as Holcomb C3-R® and Intacs®?
  • Do you feel there is no hope and depressed at times?
  • Are you concerned about your Keratoconus getting worse in the future?

In contrast, if you answered YES to any of the above. You may be a candidate for “modern day” Keratoconus procedures that can change your life AND avoid you ever needing a cornea transplant.

It may have been many years that you have suffered from Keratoconus. For that reason, some people think it is too good to be true that something now can be done.  This website WILL provide you with hope that there are other treatments.  You can regain what you’ve lost – just like thousands of our patients. Gold medalist Steven Holcomb did, thousands of other people did…and now you can too.  There IS hope!

What is Keratoconus?

First of all, Keratoconus (also known as Pellucid) is a progressive non-inflammatory disorder that causes a characteristic thinning and cone-like steepening of the cornea. This steepening results in distortion of vision, increased sensitivity to glare and light and an associated reduction in visual acuity. Even more, these symptoms usually appear in the late teens and early twenties.

Keratoconus may progress for 10-20 years and then can slow or even stabilize. Each eye can be affected differently.  Hence, this can result in a dramatic decrease in the ability to see clearly even with corrective lenses. (Note: as keratoconus and pellucid are the same disease process, any reference to “keratoconus” on this site also applies to “pellucid” as well.)

Keratoconus is now more common than ever before.

Furthermore, new research shows Keratoconus is much more common today than it was in past. Years ago, Keratoconus occurred in 1 in 2000 people, now it is 1 in 500, a 400% increase. No one is sure why there was been an increase in Keratoconus, but this is concerning.

Rigid gas permeable contact lensesEyeglasses or soft contact lenses may be used to correct the mild nearsightedness and astigmatism in the early stages of keratoconus. As the disorder progresses and the cornea continues to thin and change shape, rigid gas permeable (RGP) contact lenses can be prescribed. The contact lenses must be carefully fitted and frequent checkups and lens changes may be needed to achieve and maintain adequate vision.

Therefore, it is not uncommon to develop intolerance to RGP contacts characterized by foreign body sensations, light sensitivity, irritation, and discomfort. Corneal scarring occurs in more advanced cases and further reduces vision. Until now a corneal transplant (penetrating keratoplasty) was the only option available to advanced Keratoconus patients.

Before and after intacs

Cause of Keratoconus

The cause of the weakening is due to an imbalance of enzymes within the cornea itself that leads to high levels of damaging “reactive species” chemicals. Different types of reactive species include superoxides, hydrogen peroxide, and nitric oxide.  Even more, these substances essentially are free radicals that cause oxidative damage to the cornea.

Cause of Keratoconus

Likewise, research suggests that patients with keratoconus cannot clear away the normal amount of reactive species that are normally produced. The reason for poor clearance is that the good enzymes (Catalase and Superoxide dismutase) are not functioning properly. Which leads to the toxic accumulation of the reactive species and eventual damage in the cornea from the buildup of reactive species.

There are some genetic reasons that explain why the good enzymes do not function properly. Non-genetic sources can also increase the reactive species. Such sources include ultraviolet light sun exposure, eye rubbing, poorly fit contact lenses, and chronic eye irritation. All these cause an increase in reactive species (free radicals).

Most noteworthy, it is for these reasons we recommend that all patients with keratoconus protect their eyes by wearing 100% UV blocking sunglasses with the wrap-around design. The wrap-around design minimizes light coming in from the sides. It’s also important to avoid eye-rubbing and have a comfortable contact lens fit if contacts are being worn.

Misleading Advice from other Doctors.

Furthermore, some doctors misadvise their patients that “hard contact lenses hold the cornea and stop it from progressing.”  Unfortunately, this is not the case.  If someone’s head is expanding, wearing a baseball cap will not stop the head from expanding.

The ONLY method to stop the worsening of Keratoconus is with corneal crosslinking treatment.

Even more, some patients take a “wait and see” approach with Keratoconus. The risk of waiting is that as the cornea continues to bulge out and get worse, the back layer of the cornea can rip open. When this happens to the progressively bulging cornea, the internal eye liquid rushes in and swells up the cornea. The same way a dry sponge soaks up water and becomes very thick.

These photos below show a cornea swollen up like a soppy, wet sponge after it split open. If this happens to you, it will take 3-6 months of non-usable vision until this fluid goes away. When it eventually does, the cornea will have a lot of new scarring and vision will be permanently worse compared to before it ripped open. The good news is that this devastating damage can easily be prevented with the 30-minute, non-invasive, 1-day recovery Holcomb C3-R® – it will give you important peace-of-mind.

Swollen Cornea Holcomb c3-r treatment

Living with Keratoconus

Keratoconus is a progressive non-inflammatory disorder that causes a characteristic thinning and cone-like steepening of the cornea.  A new study has shown that Keratoconus is on the rise. 1 in 500 people has the disease.  The disease thins the cornea and forms it into a cone-like shape.

What are the Symptoms?

As the cornea develops an irregular shape, symptoms include progressive nearsightedness, blurred vision and sensitivity to light and glare. As a result, frequent prescription changes to eyeglasses are often needed with every visit to the eye doctor. Patients also tend to excessively rub their eyes, have difficulty seeing at night and often get headaches.

What is it Like to Live with Keratoconus?

Visit your eye care practitioner – From a medical standpoint, the number one thing you can do is regularly visit your eye care practitioner, educate yourself by asking questions and follow all their instructions.

Be open – Best practice for preparing for the emotional and psychological effects it to be open and discuss the subject freely with your family and friends so they understand what you are going through.

Sharing with people – A good method to feel reassured is to talk with people who are currently going through the same thing. Finding common experiences and sharing with people who understand can be rewarding.

Adapting to the condition – It is going to be an ongoing process of adapting to the condition, but remember, adapting is not the same as surrendering.

Keratoconus Treatments

Holcomb C3-R® or Corneal Collagen Crosslinking with Riboflavin: A groundbreaking treatment developed by Dr. Brian Boxer Wachler. The eye practitioner applies a solution rich with vitamins onto the eye and is stimulated with a special UV light. The procedure rebuilds weakened collagen and helps strengthen the cornea to halt progressive loss of vision, while preserving current vision.

Intacs®: Also known as keratoconus inserts, Intacs® are two tiny, thin plastic rings that are carefully inserted into the mid-layer of the cornea. They improve the corneal curve of the eye to regulate the stability and clarity of vision. Intacs® become more effective when combined with Holcomb C3-R® and can be done on the same day.

Keratoconus Athlete Wins Gold and Double Bronze Medals!

Steven Holcomb, U.S. Bobsled Driver and Keratoconus Patient Wins The 2010 Gold Medal 4-Man

Bobsled – First in 62 Years!  In 2014, he won two Silver medals in Sochi – making history again!

 Also covered on NBC’s Today Show


The Steven Holcomb Story

All eyes have been on Gold and double Bronze Medalist U.S. Bobsled driver Steven Holcomb since he made history February 27, 2010 by driving his ominous sled named the “Night Train” to glory, winning the first U.S. 4-man Gold in 62 years, which was covered the Today Show and many other shows.

Steven Holcomb celebrating winning gold medal
Steven Holcomb with Dr. Brian after bringing home the Gold – first time in 62 years.

He followed that up at Sochi in 2014 by winning two Bronze medals, making history again.  Steven is now the MOST successful American bobsled athlete of all-time with three Olympic medals.

However, it wasn’t always this way for our patient, Steven.  Steven had Keratoconus, a devastating degenerative eye disease that weakened his cornea, the outer lens of the eye.  In 2007, Steven’s Keratoconus worsened to the point of making him legally blind and Steven was put on the cornea transplant list. Steven didn’t want to put his teammates’ safety at risk due to his failing eyesight.

He officially retired from his beloved sport in June of 2007.  Steven had been an athlete his whole life and was training and competing for over a decade to win a medal in Bobsled.  At that time, his hope for a medal had vanished. But the U.S. Team, U.S. Bobsled Federation, his teammates, and coaches would not let him stay retired. They knew there must be something out there to keep him in the sport and competing. They saw potential in Steven that could be realized if his vision could be restored.

Watch videos about Steven Holcomb and Holcomb C3-R® Treatment.

They researched alternatives to the risky and painful cornea transplant surgery, the traditional treatment for Keratoconus.  That is how they found me. I was able to treat his Keratoconus with a non-surgical treatment called Holcomb C3-R®, a combination of vitamin applications and light to strengthen the cornea. 

Following that, I placed an insertable contact lens to further improve his vision. Steven immediately came out of retirement with his new eyesight in early 2008. 

This enabled Steven and his “Night Train” to go on to win the World Bobsled Championship in 2009, the first the U.S. had done in 50 years.  Steven and the Night Train became the top rated bobsled team in the world.  Holcomb C3-R® is credited for saving Steven’s eyesight. 

Steven Holcomb celebrating winning gold medal
Celebrating Steven’s World Championship in 2009 (journalist Alan Abrahamson, right).

The U.S. Bobsled Team paid for Steven’s Holcomb C3-R® procedure because they had extensively researched it and were confident with its results. Steven went from being legally blind and retired to having great vision and World Champion – An incredible comeback.

Then on February 11, I went to Vancouver for a press conference with Steven and the U.S. Bobsled team to discuss Steven’s remarkable comeback (or “second chance,” as Steven says) and do the final eye exam before sending him off to race.  

Dr. Brian with Steven Holcomb celebrating gold medal win
Steven and Dr. Brian just after Steve and the “Night Train” won Gold – first U.S. Bobsled Gold in 62 years.

Keratoconus Olympic Gold

On February 26 and 27, I was at the bobsled track with my family to support Steven and the “Night Train” in their quest for Gold. I routinely posted updates on our Facebook, Twitter, and blog feeds. Moments after Steven crossed the finish line winning first place and the Gold, I had tears streaming down my face, hugging my wife and family. It was quite an emotional day for many there as history was made on more than one level. We are all so happy for Steven and his team – they earned it!

Due to Steven’s great success the C3-R® procedure was renamed Holcomb C3-R® on April 9th, 2010 on The Doctors, Dr. Phil’s highly regarded medical talk show. This was the first time a medical procedure had been named in admiration of a Gold Medal athlete. Both Dr. Brian and Holcomb C3-R® are now known worldwide.

Steven Holcomb’s but now I can see bookSteven’s book – But Now I See

Follows his journey through this difficult time to the present, where he is living his dreams for which he worked his entire life. His story has been inspirational to millions who suffer from Keratoconus and were unaware of alternative treatments to the painful cornea transplant. Steven’s story brings hope to those who thought they would just have to live with the devastating vision loss from Keratoconus or undergo a painful cornea transplant.

Steven’s book details his comeback and is widely available at book sellers. If you have Keratoconus, then his book is a MUST read.

Steven’s story is an inspiration to millions of people. Steven says he was given a “second chance” and now other people can also have a “second chance” with these procedures that we perform almost daily…for over 15 years …for patients who come to us from all over the country.   That is why we do what we do here.  It is all about changing lives for the better.

Our staff can provide you with more information and answer your questions. Please call 310-594-5210.

Warmest regards,


Brian S. Boxer Wachler, MD

Watch the historic naming of Holcomb C3-R® on Dr. Phil’s “The Doctors” daytime TV show!

Keratoconus Featured on NBC’s TODAY SHOW

Holcomb C3-R® Saves Student’s Vision, Life Restored!

What You Need To Know

Is there a website with more information about Boxer Wachler Vision Institute and how you handle Keratoconus patients?

Yes, you can find more information about the entire process and procedure at

I am fine wearing my contacts right now. That means I do not need to do anything else, right?

In contrast, Keratoconus is a degenerative condition that can silently lead to further vision loss and decreased ability for correctible vision in glasses and/or contacts. Left untreated, Keratoconus can result in the need for a cornea transplant.

Even though you may not be having a major problem right now, the condition quietly progresses. Hence, the longer you wait to treat Keratoconus, the harder it is to treat and the less chance there is that you will remain comfortable in your contacts. We like the analogy of treating the condition while it is still a mole hill instead of waiting to eventually treat Mt. Everest. This is the reason to consider having Holcomb C3-R® at the earliest sign of Keratoconus.

Holcomb C3-R® can “lock in” the Keratoconus to prevent future disease worsening. Imagine the peace of mind you would have at night if you did not need to worry about your Keratoconus getting worse and do not need a cornea transplant!

Is Holcomb C3-R® a surgery?

No. Holcomb C3-R® is typically a one-time non-invasive procedure/treatment, not a surgery. In 2003, Dr. Brian invented the 30 minute, non-surgical Holcomb C3-R® that strengthens your cornea. Holcomb C3-R® addresses the underlying cause of Keratoconus. Weakened collagen fibers. This treatment literally strengthens those weak fibers by creating new crosslinks. The amazing aspect is that your recovery is just one day. The day after your procedure, you can be back to all your normal activities.

How did Dr. Brian invent Holcomb C3-R®?

Many have referred to Dr. Brian as a “genius” and “America’s TV Eye Doctor.”

Dr. Brian has a natural gift for seeing the potential in different aspects of surgical techniques and “connecting the dots,” therefore creating new breakthrough procedures that can change thousands of lives.

He developed a proprietary technique for non-invasively strengthening the cornea that has given thousands of people the peace of mind to know that their Keratoconus is not progressing and that they will likely never require a cornea transplant.

Why did my doctor not tell me about this?

Many cornea transplant surgeons do NOT want you to know about Holcomb C3-R® and Intacs® since they can prevent patients from needing transplants. Which is the livelihood of a cornea transplant surgeon. Dr. Brian has always advocated for what is best for patients.

Is there a doctor close to me that performs Holcomb C3-R®?

Because of the proprietary nature of Holcomb C3-R®, it is ONLY available at the Boxer Wachler Vision Institute in Beverly Hills. Along with Holcomb C3-R®, Dr. Brian used his genius to create Intacs® for Keratoconus in 1999, I-Brite Eye Whitening and fortified LASIK.

My eye doctor told me that my RGP (hard) contact lenses hold my Keratoconus back from progressing. Is that true?

No. This is a myth. Some optometrists think that a contact balancing on top of a cornea can magically push the cornea back or stop it from bulging. To say that a contact stops Keratoconus from progressing is like saying wearing a baseball cap will prevent someone’s skull from expanding. It simply does not happen. Contacts need to be updated when the keratoconus progresses. The only proven, non-invasive way to stop keratoconus from progressing is with Holcomb C3-R®.

What are Intacs® and what do they do?

Intacs® are plastic rings placed under the surface of the cornea to improve its shape. Intacs® help to reshape the steep cone. You typically will not feel them in the same way you might not feel a dental filling for a cavity. Although patients may experience some improvement in their uncorrected (natural) visual acuity, the main purpose of the Intacs® procedure is to help flatten the area of the cornea that is irregularly steepened, improve quality and “best corrected” vision with glasses or contact lenses.

Above all, every patient is different. Some patients are highly progressed and cannot wear contacts or glasses comfortably. Their goal would be to be able to wear contact lenses and/or glasses successfully. Other patients may be newly diagnosed and wearing soft contact lenses. Consequently, their goal would be to flatten the cornea (with Intacs®) and stop the worsening of Keratoconus (with Holcomb C3-R®), therefore helping to remain comfortable in soft lenses and have a better quality of vision, including night vision, in soft contacts or glasses.

If you do not live locally, Dr. Brian can perform a complimentary record review for preliminary determination of candidacy for Intacs®. This is very common for him to do.

Which is done first? Intacs® or Holcomb C3-R®? Can I do them both at the same time?

First of all, we routinely perform both procedures on the same day. Dr. Brian has perfected the technique for doing so. First, he places the Intacs® and then we perform the Holcomb C3-R® right afterwards. As a result, we found that doing both procedures on the same day can provide additional lines of improvement on the vision chart.

Increasing the flattening of the cornea versus performing these procedures on different days. Maximum results are obtained when doing Intacs® and Holcomb        C3-R® on the same day, in that order. Intacs® is seven minutes per eye and Holcomb C3-R® is 30 minutes (we treat both eyes at the same time). You will be in our office for approximately 3-4 hours on the day of the treatments between check in and check out.

Likewise, your cornea is like a tub of butter, soft and moldable. This is the ideal time for Dr. Brian to place Intacs® to reshape the cornea and flatten the cone. Then, immediately after Intacs®, Holcomb C3-R® helps to make the cornea hold together more, like a solid stick of butter, firm and less moldable. This is the reason it is best to combine BOTH procedures during the same visit rather than coming back later for Intacs®.

Is there anyone near me who performs Intacs®?

Furthermore, while there are some doctors who have recently started performing Intacs® procedure, it is unlikely that they have the level of experience that Dr. Brian possesses. Seems like, these doctors are usually unaware of the rationale for using one segment versus two segments of Intacs®.

Additionally, they often do not realize the location of placement of Intacs® varies from patient to patient. It is critical that Intacs® are rotated and placed differently for each patient based on the location and severity of Keratoconus. This is all part of Dr. Brian’s proprietary Intacs® technique. The question you might want to ask yourself is: Do you want an expert who knows how to place Intacs® or an eye surgeon with limited experience?

Can Dr. Brian help if I have had previously unsuccessful Keratoconus surgery?

Yes. Dr. Brian can fix surgery of other doctors who attempted to do Intacs® or other Keratoconus treatments that resulted in their patients vision worsening. Dr. Brian is like a “salvage diver” – he knows how to investigate and fix the problem to unlock your vision potential. As the saying goes, “It is better to get it done right the first time.”

Dr. Brian is regarded as the inventor of these procedures and has performed them thousands of times. He has been performing Intacs® since 1999 and Holcomb C3-R® since 2003. At the end of July 2004, the FDA officially recognize Intacs® as a treatment for Keratoconus, thanks in part to Dr. Brian’s peer-reviewed, published study.

Patients fly in from all over the country to have Intacs® performed by Dr. Brian. He is also the only doctor in the United States performing the companion Holcomb C3-R® procedure, which is aimed at halting the worsening of Keratoconus.

Does the Intacs® procedure alone (without Holcomb C3-R®) stop the worsening of Keratoconus?

No. On its own, Intacs® flattens the cornea but does NOT prevent the cornea from further steepening. Holcomb C3-R®, on its own or combined with Intacs® is the procedure that can stop the worsening and corneal thinning. Current data shows a 99.3% success rate of halting the worsening of Keratoconus after Holcomb C3-R® with a one-time treatment. That means less than 1% of patients need a second Holcomb C3-R®.

Are there side effects with Intacs®?

There are minimal side effects from Intacs®. Some patients note some light sensitivity during the first 1-4 weeks after the procedure, as well as some fluctuations of vision the first 1-3 months.

The advantage with Intacs® is that they are removable and exchangeable, which reassures people. There is no significant scar tissue and because the Intacs® are placed outside of the visual axis there is no risk in that area (the middle area of the cornea where light focuses through the eye). The Intacs® can remain implanted in your eye indefinitely. They are made from a material that has been implanted in eyes for over 70 years.

Dr. Brian walks you through the procedure carefully and keeps you relaxed throughout. Our youngest Intacs® patient was 9 years old and Dr. Brian has even performed Intacs® on his brother-in-law and sister-in-law in 2000, so it is clear that he trusts the safety of this procedure.

We have had great success in helping to avoid cornea transplants in nearly all patients. There are a handful of patients who had a cornea transplant after Intacs®. In these cases, the patients had very severe Keratoconus and were advised to have transplants. They decided to have Intacs® placed to delay the need for their transplants, which in most of these cases gave the patients 1-2 years of delay.

Can I wear contact lenses after having Intacs®?

Yes. During the first month after the procedure, the Intacs® will continue to heal and the shape of the cornea will change. This means that your prescription may fluctuate during the healing process. You can wear glasses during the first 2-4 weeks of healing. After two weeks of healing, you can begin the process of being fit with new contact lenses.

During the rest of the three month healing process, your prescription may continue to change and you may need several fittings to reach your final prescription. Remember, Intacs® and Holcomb C3-R® procedures are performed to control your Keratoconus and patience is necessary during this important healing time.

After Holcomb C3-R® only (without Intacs®), you can typically resume use of your current contact lenses the day after the procedure. You may need to be refitted for contact lenses after three months.

Can Keratoconus patients be candidates for Insertable Contact Lenses (Visian ICL)?

Some Keratoconus patients are candidates for the Visian ICL lens, based on treated Keratoconus and amount of nearsightedness. Generally, the best outcomes are with patients with less than 5 diopters of astigmatism. Prior to the ICL procedure, most patients need to undergo Holcomb C3-R® with/without Intacs® to stabilize their Keratoconus three months prior to Visian ICL.

Are there any other treatments that can improve my vision?

Also, Dr. Brian can perform a procedure called CK (conductive keratoplasty) to help reduce some of the astigmatism and further improve vision. This can also assist with obtaining lower levels of postoperative astigmatism, which aids in the fitting of soft toric contact lenses or RGP contact lenses. This procedure will not permanently eliminate your need for contact lenses or glasses, but it is designed to improve the overall quality of vision you obtain with your contact lenses or glasses.

13 Myths About Keratoconus

Myth #1: “Hard contacts will prevent my Keratoconus from getting worse.”

The truth is that no contact lens stops or slows down Keratoconus worsening. Contacts merely sit on top of the cornea, like a hat on your head. If your head was expanding, the hat will not stop that expansion. Eventually you will need a new hat size. As a result, the same thing happens with hard contact lenses and Keratoconus.

Saying hard contact lenses hold the cornea back is like saying a surfer somehow pushes the wave back. The only means to prevent Keratoconus from progressing is with crosslinking, namely Holcomb C3-R® – 99.3% of people are stabilized after just a single treatment, which is the highest stability rate of ALL crosslinking techniques.

Myth #2: “Keratoconus only occurs in young people.”

Although most people diagnosed with Keratoconus are younger than 30 years old, there are plenty of patients in their 30’s, 40’s and 50’s with newly diagnosed Keratoconus. For reasons unclear to us, Keratoconus now occurs in 1 in 500 compared to 1 to 2000 in the past.

Myth #3: “When I turn 40, my Keratoconus will stabilize on its own.”

There is no crystal ball to predict when someone’s Keratoconus will “burn out.” Sometimes it keeps progressing until a cornea transplant is needed. Furthermore, if Keratoconus does eventually “burn out,” this is generally after that person has lost a considerable degree of vision. While, Keratoconus has a “mind of its own” and is unpredictable since it is a progressive disease. It makes sense to stop the worsening and preserve vision as soon as one is diagnosed. This includes children as well.

Myth #4: “Holcomb C3-R® is painful and will make me have a cataract eventually.”

Most noteworthy, traditional crosslinking is painful since the epithelium is scraped off. The non-invasive Holcomb C3-R®, our proprietary crosslinking, is typically a 100% pain-free procedure with full recovery by the next day. All the studies show crosslinking has no effect on cataract development later in life.

Myth #5: “If I have Intacs®, I will feel them floating around.”

Intacs® are placed between the layers of the cornea below the surface. Intacs® are immediately locked in place by natural tissue forces and are strongly sealed by the healing process. They never “float” around. Patients typically do not feel Intacs® since they are positioned below the surface – you will not feel the Intacs® much like a dental filling is not felt because the filling is inside a tooth.

Myth #6: “Intacs® need to be replaced every few years.”

Finally, the truth is Intacs® never degrade or wear out and do not need replacement for those reasons. They are stronger than the cornea and will not break even if you were struck in the eye.

Myth #7: “If I have Intacs® alone, that will stop the worsening of my Keratoconus.”

Years ago, Dr. Brian discovered the power of Intacs® in reshaping Keratoconus corneas and improving vision. However, he understood that they did not strengthen the weakened collagen fibers. That is the reason he invented Holcomb C3-R® as a vital partner to Intacs® to stabilize Keratoconus. When used together, Intacs® and Holcomb C3-R® can improve vision AND stabilize Keratoconus.

Myth #8: “Intacs® and Holcomb C3-R® are too expensive and I cannot afford them.”

This is likely not to surprise you. Several people who can easily afford their Keratoconus treatments secretly feel guilty about spending money on themselves rather than on their kids or others in their lives. The truth is that your loved ones want you to enjoy life. You work hard and deserve to take care of yourself now. Going through life without seeing as well as you can and not fully enjoying your life, hobbies, job, school and sports is simply unfair. Your Keratoconus treatments are expected to serve you the rest of your life.

Depending on your situation, your treatments could wind up costing you less than a few hundred dollars a month through patient financing programs that we offer. As for the cost of the procedures, they are much more than “vitamins and light” and “a piece of plastic.” They are the end-product of scientific research spanning more than 20 years are requiring more than $20 million dollars. Our Intacs® and Holcomb C3-R® techniques are “state-of-the-art.”

We expect you to be amazed at how much better you see driving (especially night driving), seeing people’s faces, watching TV, playing sports and enjoying weekend activities to name a few things. We expect you will surprise yourself and be proud to have the procedures, proud that you did something good for your health, well-being and your future.

Myth #9: “I can save money by going to a nearby clinic that takes insurance for Intacs®.”

There are cheap versions of every kind of medical procedures. People come to us all the time unhappy that they tried to save a few dollars by going to a cheaper eye center or one that took their insurance. You know the saying, “penny wise, pound foolish?” When it comes to your health, you certainly do not want a false bargain. Frankly, Intacs® and Holcomb C3-R® are not the lowest priced Keratoconus procedures out there. They are, in fact, premium procedures from one of the world’s leaders in Keratoconus – Brian S. Boxer Wachler, MD.

Similarly, there are several reasons for our fees, including our proprietary technology, high quality standards, a long term track record and exceptional customer service for our patients. Our patients have Dr. Brian’s cell phone in case they need him after hours. Saving money by having cheaper Intacs® and crosslinking is not savings at all if it fails to help your vision and your Keratoconus or disappoints you so much that you wished you had never had it performed by another doctor in the first place.

Myth #10: “My Keratoconus is too far gone and cannot be helped.”

In the past, many people with Keratoconus have been told – by their eye doctors – that their only options were hard contact lenses or an invasive and painful cornea transplant. This medical device is antiquated and no longer applies. At the Boxer Wachler Vision Institute we have made amazing technological advances. Today, Boxer Wachler Holcomb C3-R® and Intacs® helps people who could not be helped in the past! Best of all, our treatments typically give people the peace of mind of never needing to worry about having a cornea transplant in the future.

Myth #11: “I can book my flight and hotel, fly out to Beverly Hills, then be told that I am not a candidate for any procedures.”

Seems like, this NEVER happens and here is the reason: Dr. Brian routinely performs complimentary record reviews for out-of-town patients to make preliminary recommendations regarding whether or not you are a candidate. In our practice 58% of Keratoconus patients travel from out of town (including out of state and out of country). This gives us certainty that we can help you BEFORE you arrive, so that you are able to confidently schedule your travel arrangements.

During your three-day trip, you will: 1) See Dr. Brian; 2) Have your Keratoconus treatments with him; and 3) Have him examine you at the one day checkup. We will help coordinate your follow up doctor visits back home as well. Patients routinely come to us from all over the United States and the world. Coordinating your aftercare back home with a local doctor is a normal routine for us.

Myth #12: “All Intacs® and crosslinking procedures are the same.”

Above all, do NOT make this mistake. There are no shortage of eye surgeons jumping on the “Keratoconus bandwagon,” that are now offering Intacs® and crosslinking. The Boxer Wachler Vision Institute performs more Intacs® and crosslinking procedures than anyone else. Likewise, no one matches our combination of advanced technology, quality and service.

Quality matters, especially when you consider how important this is for your future. The technology, engineering, functionality and comfort of your Keratoconus treatments matter. So, when it comes to your health and well-being, your personal safety and enjoyment of life matter!

Myth #13: “I am doing just fine with my contacts, so I have nothing to worry about.”

Therefore, you do not have to worry as much as someone suffering from contact lens issues. But you should worry a little. Certainly, Keratoconus is unpredictable and progressive. “It has a mind of its own” since it does not follow any rules. Holcomb C3-R® would be recommended at a minimum to strengthen your cornea and not to worry about future vision loss. It is like an “insurance policy for your eyes.” Thousands of good people now sleep as sound as a baby wrapped in a warm blanket after Holcomb C3-R®

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