Corneal collagen cross-linking with riboflavin, also known as CXL, CCR, CCL and KXL, involves a one-time application of riboflavin solution to the eye that is activated by illumination with UV-A light for approximately 5 minutes(High Fluence CXL).The riboflavin causes new bonds to form across adjacent collagen strands in the stromal layer of the cornea, which recovers and preserves some of the cornea’s mechanical strength. Studies show that the corneal epithelial layer should always be removed to increase penetration of the riboflavin into the stroma for cross linking to work.
Clinical trials began in Germany and Italy in 2002, and cross-linking has shown success in retarding or stopping progression of the disease. Results from an Australian study published in 2008 showed stabilization in all treated eyes, and a slight correction in visual acuity in most patients. The procedure, with epithelium removed, is approved for use throughout Europe,and its now FDA approved for use in the USA where its approved for use in keratoconus and post LASIK ectasia.
In most cases, collagen cross-linking may also be combined with other treatments to improve corneal asymmetry or optical refraction (improving vision at the same time). Combining CXL with other vision improving procedures is called Cross-Linking -Extra. Successful treatment methods include corneal ring segment inserts (Intacs or Ferrara rings), Topography Guided Laser(our prefered method), or Keraflex. Corrective lenses ( scleral lenses) are normally required after these treatments, but with smaller, more normalized prescriptions. Increased corneal symmetry allows for more comfortable contact lens wear, often of daily disposable lenses. These newer methods may have an important role in limiting deterioration of vision, increasing unaided and uncorrected vision, and reducing the case for corneal transplantation.
DO YOU WANT TO FIND OUT CROSS-LINKING EXTRA BENEFITS OVER SIMPLE CROSS LINKING. CALL US ON 011 346 5025/ 0815455385 MONDAY – FRIDAY 8AM- 5:00PM. Safesight Cataract and Eye Laser Centre, Waverley, Johannesburg.