Corneal Collagen Crosslinking
Corneal Collagen Crosslinking CXL is a technique used to strengthen the cornea. It is primarily used to halt the progression of keratoconus but is also used as treatment for the following indications;
- Iatrogenic keratectasia after refractive surgery
- Corneal ectasia
- Prior to refractive surgery to prevent subsequent ectasia
- Pellucid marginal degeneration
- Bullous keratopathy
- Microbial keratitis and corneal ulcers
- Donor tissue modification prior to keratoplasty
- As an adjunct to orthokeratology
What is Corneal Collagen Crosslinking?
CXL of the cornea involves applying riboflavin eye drops to the eye and then exposing the cornea to ultraviolet light with a wavelength of 370 nm. It is a new approach which increases the mechanical and biochemical stability of corneal stromal tissue by creating bonds between the collagen fibrils in the cornea. Treatment takes approximately 30 minutes.
How effective is Crosslinking in treating Keratoconus?
CXL is proven to help reduce astigmatism, improve best-corrected visual acuity (BCVA) and maximum simulated keratometry values reducing myopia to a variable degree.
What corneal thickness is suitable for CXL?
The corneal thickness should be ≥ 400 microns in the thinnest area.
How many times do we need to apply treatment: The majority of cases need only one treatment session per eye.
What are the adverse events of the procedure:
The risks associated with this procedure are minor relative to the morbidity of advanced disease. Nevertheless, as with any surgical procedure, there can be complications and occasionally people can lose vision due to infection and scarring.
Which patients benefit from CXL?
The best candidates for this therapy are patients with keratoconus or post refractive surgery ectasia with documented progression of the problem. We gauge progression by observing changes in refraction, visual acuity, and corneal shape (topography and tomography).
What is new in CXL?
The Avedro KXL system is now available at the Milford Eye Clinic. It incorporates the latest advances in CXL, delivering more intense UV irradiance and better focus. These improvements have resulted in shorter treatment times which helps to reduce discomfort.