Corneal Cross-Linking

About Corneal Cross-Linking

Corneal cross-linking (CXL) is a treatment for patients with keratoconus which can prevent their condition getting worse. CXL is successful in preventing the condition deteriorating in more than 90% of cases. Keratoconus worsens as the cornea weakens. CXL uses ultraviolet light and vitamin B2 (riboflavin) drops to harden the cornea. Together, they cause fibers within the cornea to cross-link – or bond more firmly. This treatment emulates the normal age-related hardening of the cornea, which is known as natural cross-linking

Conditions associated

Keratoconus

Keratoconus is a progressive thinning of the cornea. The cornea is the clear front window of the eye, which, along with the intra-ocular lens, focuses light on to the retina. The cornea normally is a smooth, round dome-shaped structure; however in keratoconus it becomes very thin and irregular and it starts to protrude from the centre or below the centre like a cone. This causes blurry vision that is often not completely correctable with glasses.

Causes

Keratoconus is multifactorial in origin but there is a strong genetic component which makes it more frequent in certain parts of the world or within certain families. . it can also be related to frequent eye rubbing which leads it to be more progressive.

CXL treatment

The treatment is recommended only for patients whose scans show that their keratoconus is getting worse, or for those who are at particularly at high risk of their keratoconus deteriorating such as children. Because of natural cross-linking with age, keratoconus usually stops getting worse by the mid-30s, so CXL is not normally required for older patients.

This treatment is minimally invasive and local anesthesia drops are instilled so that the procedure is not painful. Vitamin B2 (Riboflavin) drops are instilled frequently while the ultraviolet light is applied on the cornea for 10-30 minutes. This treatment strengthens the cornea and slows down or prevents the progression of the disease. The treatment aims to improve the vision and the need for glasses or contact lenses will still be required, however some keratoconus cases can improve slightly with the treatment. The corneal cross linkage procedure can be combined with other corneal procedures in parallel or in sequence such as intracorneal ring implant or specific map surface laser.

Corneal Cross-Linking Specialists

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Dubai
Abu Dhabi

Dr. Miguel Morcillo

Consultant Ophthalmologist in Cornea, Cataract and Refractive vision correction surgery

Dr. Miguel Morcillo is a Consultant Ophthalmologist specialising in Cornea, Cataract and Refractive (Vision Correction – LASIK, LASEK, TransPRK) Surgery at Moorfields Eye Hospital Dubai in Dubai Healthcare City. Dr. Miguel holds a Spanish Degree in Medicine from the Universitat de Valencia. He completed his Residency in Ophthalmology under the MIR (Medico Interno Residente) system of the Spanish Ministry of Health. He has more than 25 years of experience, most of which was attained in Spain. He also worked in Italy and finally moved to the UAE in 2017 and has been practising in the UAE since that time. Dr. Miguel started his career working with Clinica Baviera, the largest private ophthalmology group in Europe, in Madrid and Valencia. He helped develop many of the refractive treatments offered today, such as LASIK, LASEK, ICLs and multifocal IOLs, in addition to collaborations with other hospitals to provide high-quality cataract and refractive surgery to patients. Dr. Miguel trained in cornea surgery at NIIOS Eye Institute (Rotterdam) and, since then became an experienced educator for other surgeons in the fields of the anterior segment and refractive surgery. He has been a member of “Surgical Eye Expeditions International” since 1999, an American non-government organisation that arranges eye camps worldwide. Dr. Miguel has assisted several eye charity camps in numerous countries of Africa, in addition to Peru, Panama and India, providing free eye care and performing surgeries to those who could not afford it in less developed areas. His research efforts include surgical topics and outcomes such as Ultrathin LASIK, Keratoconus screening, ICLs, and multifocal IOLs, among others. He has presented various papers in national and international congresses and journals and organised educational courses on refractive surgery for peers and opticians. He is a member of Sociedad Española de Oftalmologia (SEO), the Panamerican Association of Ophthalmology (PAAO) and the European Vitreoretinal Society (EVRS). He is also the recipient of the Dr. P C Mahendra Memorial ACOIN International Award in India in recognition of his charitable work with people in need.

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Dr. Nadim Habash

Consultant Ophthalmologist in Cornea and Ocular Surface Diseases

Dr. Nadim Habash is an American Board-Certified Consultant Ophthalmologist specialising in Cornea, Ocular Surface Diseases, and General Ophthalmology at Moorfields Eye Hospital Dubai in Dubai Healthcare City. Dr. Nadim undertook his speciality training at George Washington University in Washington D.C., U.S.A., where he also served as Chief Resident. He then acquired an additional Cornea and External Disease Fellowship at the University of Florida, Gainesville, U.S.A. Dr. Nadim is a Diplomate of the American Board of Ophthalmology and a Fellow of the Royal College of Surgeons of Canada FRCS(C). Over the past 40 years, Dr. Nadim has had extensive experience in Corneal transplantation and Anterior Segment Diseases in several countries, including the United States of America, the Kingdom of Saudi Arabia and the United Arab Emirates. Dr. Nadim has worked and held leadership and academic positions in prestigious institutions, including the University of Ohio at Toledo, Ohio, U.S.A., the King Faisal Specialist Hospital and the King Khaled Eye Specialist Hospital in Saudi Arabia, and at the American Hospital Dubai, where he held key positions including Chief of Medical Staff, Assistant Chief Medical Officer and Director of Ophthalmology. Dr. Nadim published several papers about Corneal transplantation, chaired many scientific conferences and symposia, and participated actively in teaching medical students and Ophthalmology residents. Throughout his career, Dr. Nadim held memberships in several scientific organisations, including a fellowship of the American College of Surgeons, the American Academy of Ophthalmology membership, and many regional and local societies

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Dr. Osama Giledi

Consultant Ophthalmologist in Cataract, Cornea and Refractive Vision Correction Surgery

Dr. Osama Giledi is a Consultant Ophthalmologist specialising in Cornea, Cataract and Refractive Surgery at Moorfields Eye Hospital Dubai in Dubai Healthcare City. Dr. Osama is skilled in managing ocular surface problems, including severe dry eye and Stem cell deficiency. He performs small incision phacoemulsification for his cataract surgery and is experienced in using toric and multifocal premium intraocular lenses. Dr. Osama’s expertise in managing complex corneal conditions includes all types of modern corneal graft procedures, such as DALK and DSAEK. He has performed over 23,000 refractive surgeries, including Lasik, LASEK, Intralase LASIK and Trans PRK, and phakic IOLs. He delivers the latest treatment for keratoconus, including Intracorneal ring segments, corneal cross-linking and complex laser treatment. Dr. Osama graduated from Libya and completed his ophthalmic training in the UK, attaining a Fellowship in Ophthalmology from The Royal College of Edinburgh in 1996. He completed two years of higher subspecialty training fellowship on the anterior segment, Cornea and refractive surgery in 2003 at the prestigious Corneoplastic Unit and Eye Bank at Queen Victoria Hospital, East Grinstead. He worked as a Consultant Ophthalmologist at the Centre for Sight London and the Corneoplastic Unit and Eye Bank at Queen Victoria Hospital. Dr Osama has 22 years of experience in the UK, providing services for anterior segment, Cornea, Refractive and cataract surgery. In addition to his clinical commitments, Dr. Osama has extensive experience in teaching and training; he is a noted presenter at national and international meetings and has extensive research published in peer-reviewed scientific journals. He is a member of the Royal College Surgeons of Edinburgh, the United Kingdom & Ireland Society of Cataract and Refractive Surgeons, and the European Society of Cataract and Refractive Surgeons.

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Dr. Esmaeil Arbabi

Medical Director and Consultant Ophthalmologist in Corneal transplant, Cataract & Refractive Surgery

Dr. Esmaeil Mohammad Arbabi is a Consultant Ophthalmologist with excellent surgical experience including all types of corneal transplants (DMEK, DSAEK, PDEK, DALK, PKP), ocular surface reconstruction, complex cataract and laser refractive surgery. Prior to joining Moorfields Eye Hospital Center, he was Consultant Ophthalmic Surgeon (Cornea, Cataract & Laser Refractive Surgery) and the Lead for Refractive Services at Royal Liverpool University Hospital, Liverpool, United Kingdom. Dr. Esmaeil holds several prestigious degrees and certifications in the field of cataract and refractive surgery including MSc in Cataract and Refractive Surgery, Certificate in Laser and Refractive Surgery (CertLRS) from Royal College of Ophthalmologist and Fellow of European Board of Ophthalmology Subspecialty Diploma in Cataract and Refractive Surgery (FEBOS-CR). He is a member of Royal College of Ophthalmologists, European Society of Cataract and Refractive Surgeons, European Board of Ophthalmology, UK Cross-Linking Consortium, EYE -LAW CHAMBERS - Medicolegal Expert and Expert, Association of Personal Injury Lawyers (APIL). He is instrumental in high quality papers in various peer reviewed journals and numerous scientific and ophthalmology publications. He is also an examiner for the University of Leeds and the University of Liverpool and for the European Board of Ophthalmologist (FEBO exam).

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