By Alexandra Snyder, Fort Belvoir Community Hospital Public AffairsNovember 23, 2016
FORT BELVOIR, Va. -- 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 to slow or halt the progression of keratoconus, a progressive eye disease in which the normally round cornea thins and begins to bulge into a cone-like shape.
The shape deflects light as it enters the eye on its way to the light-sensitive retina, causing distorted vision. In some cases, patients with the disease 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 procedure that lasts approximately 60 to 90 minutes. The procedure uses liquid riboflavin and controlled ultraviolet light to build new collagen bonds in the cornea, which help recover and preserve some of the cornea's mechanical strength.
During the treatment, the top layer of the cornea is removed, which allows the riboflavin to deeply penetrate the cornea, Rivers explained. After a cross-linking treatment, a contact lens is placed in the eye to act as a bandage as the cornea heals. During the procedure, one eye is treated at a time.
The ultimate goal of a cross-linking treatment is to strengthen the cornea, which in turn slows or stops the disease's progression, 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, Rivers added.
Saverio Macrina, a West Point cadet slated to graduate in May, was the first patient to receive the treatment at the facility. He needed it to receive his commission.
"I'm grateful to the Army for providing me the opportunity to get this surgery," Macrina said. "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 [will] no longer have to do this and that I am the first of many who are helped."
Macrina's hope that he is the first of many is Rivers' hope, too. For Soldiers, he said, the progression of the disease can make it so they can only correct their vision by wearing contact lenses, which aren't approved for combat.
"[That] 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 to perform the procedure, interested military ophthalmologists in the region can 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," Rivers said. "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," Rivers said. "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."