Epithelium Off Corneal Collagen Crosslinking (CXL) Treatment for keratoconus
The superior way to perform cure of keratoconus
Indications for Epithelium Off Corneal Collagen Crosslinking (CXL) Treatment for keratoconus
- Keratoconus in Children above age 12 years
- Progressive Keratoconus in adults with increase in steepness of Cornea more than 1 Dioptre.
- Accelerated thinning of Cornea
- Post lasik bulging of cornea
- Cornea thinner than 400 um (For thinner Corneas – See Hyptotonic Riboflavin Collagen Cross Linking
- K readings greater than 60D
- Central corneal scarring
Procedure of Epithelium Off Corneal Collagen Crosslinking (CXL) Treatment for keratoconus
- Anesthetic eye drops instilled
- Epithelium removed
- Riboflavin eye drops introduced
- Penetration of riboflavin into the eye confirmed
- UV-A Radiation delivered
- Therapeutic bandage lens applied
- Patient seen next day
- 3- 4 days later to confirm healing with no infection
- 4 to 7 days to remove the lens
- 1- to 3 months thereon with topography
- Scarring of cornea
- Cornea thinner than 400
- Severe bulging
- Uniform penetration
- Stronger effect than epithelium on CXL
- Line of demarcation on ocular coherence tomography shows deeper uniform effect.
- May still be performed if C3R/Epi on show no effect.
- Delayed epithelium healing
- corneal edema
Please note. In the United States FDA has not approved cxl but is reviewing studies of Epithelium Off Corneal Collagen Crosslinking (CXL) Treatment for keratoconus. This writeup is for educational purposes only. It should serve as a basis for discussion with your keratoconus doctor. Various studies differ in the concentration of riboflavin, intensity and exact duration of uv application. Researchers are looking into chromatophores other than Riboflavin, varying wavelength of UV light.
By Rajesh Khanna, MD
Keratoconus Expert, Beverly Hills