Corneal Collagen Crosslinking with Riboflavin (C3-R®*) OR CXL
With current methods using rigid contact lens or intra corneal ring segments, only the refractive error (spectacle numbers) can be corrected, but it has very little effect on the progression of keratoconus. It is estimated that eventually 21% of the keratoconus patients require surgical intervention to restore corneal anatomy and eyesight. A new non surgical, non invasive treatment, based on collagen cross linking with Ultraviolet A (UVA, 365nm) and riboflavin (Vitamin B 2), a photosensitizing agent is now available. This changes the intrinsic biomechanical properties of the cornea, increasing its strength by almost 300%. This increase in corneal strength has shown to arrest the progression of keratoconus in numerous studies all over the world.
What is Collagen Cross-linking?
A treatment for keratoconus which has shown great success is Corneal Collagen Crosslinking with Riboflavin (C3-R®*) or CXL, a one-time application of riboflavin eye drops to the eye. The riboflavin, when activated by approximately 30 minutes illumination with UV-A light, augments the collagen cross-links within the stroma and so recovers some of the cornea’s mechanical strength. C3-R®*, developed at the Technische Universität Dresden, Germany has been shown to slow or arrest the progression of keratoconus, and in some cases even reverse it, particularly when applied in combination with intracorneal ring segments.
How is the treatment done?
The treatment is performed in our operation theatre under complete sterile conditions. Usually, only one eye is treated in one sitting. The treatment is performed under topical anesthesia (using anesthetic eye drops). The surface of the eye (cornea) is treated with application of Riboflavin eye drops for 30 minutes. The eye is then exposed to UVA light for 30 minutes. Hence, the treatment takes about an hour per eye. After the treatment, antibiotic eye drops are applied; a bandage contact lens may be applied, which will be removed by our doctor during the follow up visit. Protective eye wear, such as sunglasses (also given by us) is to be worn for a few days until complete healing takes place.
What are the risks and consequences involved?
Very few potential risks associated with this treatment have been reported so far. The Ultraviolet light dose used is designed to prevent damage to the cells that line the back of the cornea or the other structures within the eye. No lens opacities (cataracts) have been attributed to this treatment in European trials.
