For individuals living with progressive keratoconus, the prospect of treatment has often meant weighing effectiveness against a lengthy and uncomfortable recovery. Traditional corneal cross-linking, while proven, requires removal of the cornea’s outer layer—the epithelium—leading to several days of pain and blurred vision while the tissue regenerates. Now, a new FDA-approved treatment called Epioxa is changing that equation by offering an epi-on approach that keeps the epithelium intact, and Aloha Laser Vision in Honolulu is the first practice in Hawaii to bring it to patients.
Epioxa is designed for patients aged 13 and older whose keratoconus is progressing. The in-office procedure takes just 20 to 25 minutes per eye and involves applying specialized drops, fitting oxygen-enriched goggles, and delivering a controlled dose of ultraviolet light. The result is a reinforced corneal structure that slows or halts the disease’s advancement, but with a recovery that patients often compare to a mild sunburn rather than the more intense healing required by older methods.
What Is Epioxa?
Epioxa is an epithelium-on corneal cross-linking treatment that uses riboflavin drops and ultraviolet light to strengthen the collagen fibers in the cornea. Unlike the traditional epi-off method, which strips away the protective epithelial layer to allow the drops to penetrate, Epioxa is formulated to work through the intact epithelium. This innovation reduces the invasiveness of the procedure and shortens the recovery timeline significantly.
The treatment is performed in three stages: application of the treatment drops, fitting of oxygen-enriched goggles, and delivery of ultraviolet light. The entire process is completed in under half an hour per eye, and the second eye can often be treated about a week after the first. For patients who have been hesitant to pursue cross-linking due to concerns about downtime, Epioxa offers a compelling alternative.
What Stands Out About Epioxa
Preservation of the Corneal Surface
By leaving the epithelium intact, Epioxa eliminates the need for the painful healing period associated with epithelial removal. Patients experience less discomfort and can return to normal activities sooner, making the treatment far more accessible for those with busy schedules.
Shorter Procedure Time
At just 20 to 25 minutes per eye, the Epioxa procedure is significantly faster than traditional epi-off cross-linking, which typically takes about an hour. This efficiency benefits both the patient and the clinical team, allowing for a streamlined experience.
Proven Technology with a Modern Twist
Epioxa builds on more than a decade of clinical experience with corneal cross-linking. Dr. Alan Faulkner and his team at Aloha Laser Vision have been performing cross-linking for over 15 years, and their expertise ensures that patients receive care rooted in both tradition and innovation.
Insurance and Financial Support
Aloha Laser Vision has worked with Hawaii insurance carriers to establish reimbursement pathways for Epioxa, including buy-and-bill arrangements and specialty pharmacy coordination. Many patients may find the treatment financially accessible, with copayments potentially covered by Glaukos’s CareConnect program.
Who It’s For
Epioxa is intended for individuals aged 13 and older who have been diagnosed with progressive keratoconus. Ideal candidates are those whose corneal thinning and bulging are advancing, as cross-linking works best before the cornea has changed significantly. The treatment may not be recommended for pregnant individuals, those with a history of herpetic keratitis, known sensitivity to the drops, or those who have had cataract surgery without a UV-blocking lens implant.
Patients considering Epioxa will undergo a thorough evaluation that includes corneal mapping, thickness measurements, and a review of their medical history. This careful screening ensures that the treatment is tailored to each individual’s needs and maximizes the likelihood of a successful outcome.
What Makes It Worth Considering
Epioxa represents a meaningful step forward in the management of progressive keratoconus. Its epi-on design addresses one of the biggest barriers to treatment—the recovery experience—without compromising on the core goal of stabilizing the cornea. For patients in Hawaii, having access to this technology locally eliminates the need to travel to the mainland for advanced care.
The track record of the provider also adds to the treatment’s appeal. Dr. Alan Faulkner is a board-certified ophthalmologist with decades of experience and a history of introducing cutting-edge eye care techniques to the state. His leadership at Aloha Laser Vision, combined with the practice’s commitment to patient education and insurance navigation, creates a supportive environment for those exploring Epioxa.
Verdict
Epioxa is a well-conceived, less invasive option for keratoconus patients who want to halt disease progression without enduring a lengthy recovery. Its availability at Aloha Laser Vision gives Hawaii residents access to a treatment that balances effectiveness with comfort, backed by a seasoned team and practical financial support.
Frequently asked questions
Epioxa is an FDA-approved epi-on corneal cross-linking treatment for progressive keratoconus that leaves the corneal surface intact.
The in-office procedure takes about 20 to 25 minutes per eye.
Patients aged 13 and older with progressive keratoconus may be candidates, after evaluation including corneal mapping and medical history.
Patients may experience mild light sensitivity, redness, or blurred vision, similar to a mild sunburn on the eye, with a faster recovery than epi-off methods.
Aloha Laser Vision has worked with Hawaii insurance carriers to establish reimbursement pathways, and copayments may be covered by Glaukosu2019s CareConnect program.
Epioxa is offered at Aloha Laser Vision in Honolulu, led by Dr. Alan Faulkner.
