Fort Belvoir Community Hospital made history November 21 when it became the first military medical facility in the country to perform a vital sight-saving procedure.
The procedure, corneal cross-linking, was recently approved by the FDA and allows patients with keratoconus to slow or halt the progression of their disease.
Keratoconus is a progressive eye disease in which the normally round cornea thins and begins to bulge into a cone-like shape. This cone shape deflects light as it enters the eye on its way to the light-sensitive retina, causing distorted vision. In some cases, patients with it are unable to wear glasses, and in severe cases patients require corneal transplants.
“We are thrilled to extend this treatment option to patients in need,” said Army Col. Bruce Rivers, staff ophthalmologist and program director of the Warfighter Refractive Eye Surgery Program and Research Center at Belvoir Hospital. Rivers’ team was the first to perform the procedure.
Corneal cross-linking is a minimally invasive treatment that lasts approximately 60-90 minutes and halts the progression of this disease. The procedure uses liquid riboflavin and controlled UV light to build new collagen bonds in the cornea, which helps recover and preserve some of the cornea's mechanical strength. During the treatment, the top layer of the cornea is removed, which helps the riboflavin deeply penetrate the cornea, explained Rivers.
After a cross-linking treatment, a contact lens is placed in the eye to act as a bandage as the cornea heals. At this time, only one eye is performed at a time.
The ultimate goal of a cross-linking treatment is to strengthen the cornea, which in turn slows or completely stops the progression of keratoconus, but some patients will also see an improvement in the quality of their vision and a mild decrease in the amount of correction needed after treatment, added Rivers.
Saverio Macrina, a United States Military Academy at West Point cadet slated to graduate in May, was the first patient to receive the treatment at the facility. He said he needed it performed to receive his commission.
“I’m grateful to the Army for providing me the opportunity to get this surgery,” said Macrina. “My West Point doctor told me that, right now, the academy is forced to turn away applicants with the disease. My hope is that they no longer have to do this and that I am the first of many who are helped by the military offering this treatment.”
Rivers said what Macrina hopes for is also one of his biggest goals.
“When you’re in the military, if you’re not able to be deployed, your career can be cut short. When this disease progresses, it can result in patients being unable to correct their vision to a point where they’re non-deployable since they can only achieve good vision in contact lenses. But contact lenses aren’t approved for combat, which means these otherwise great service members may be forced to end their military careers before they intend to,” Rivers explained. “Before this service was available through the military, service members could also have chosen to seek this treatment by an outside provider, at a cost of up to $4,000 per eye.”
Although Belvoir Hospital is the only military hospital in the eastern United States with the machine required for the procedure, interested military ophthalmologists in the region are able to train on it and treat their affected patients- regardless of hospital affiliation.
“Ophthalmologists from Andrews (Air Force Base) and Walter Reed (National Military Medical Center) will start using the system in December,” said Rivers. “We’re happy to offer our staff and facilities to accommodate other military eye doctors in the area until they get their systems. Our goal is to care for all patients who need it.”
Corneal Cross-Linking will be available to all Tricare beneficiaries, including dependents.
“We see a lot of younger patients with keratoconus,” said Rivers. “It’s important for us to offer this treatment to everyone so that we can screen, catch, and treat the disease early, before it can do any severe, permanent damage. Eyes are one of the most important organs a person possesses and my team is thrilled to offer another way to keep them functioning at their best.”