Corneal Collagen Cross-linking with Riboflavin (C3R) with Topography Guided Laser Surface Treatment (C3R + Topo guided PRK) is a procedure that can be offered to those with early keratoconus.
Indications for Topography linked C3R
- Keratoconus
- LASIK induced ectasia
- PMCD-Pellucid Marginal Corneal Degeneration
- We now perform treatments which combine C3R with an excimer laser surface treatment. We use the advanced Concerto excimer laser (WaveLight) for the topography-guided treatment. This is only possible if the Corneal thickness is enough for both treatments and if the topography maps are found suitable for treatment.
Advantages of C3R combined with Laser Surface Treatment:
- Improves the corneal asymmetry.
- The synergistic improvement of shape, based on the C3R effect, allows us to reduce the laser treatment by approximately 50%.
- An improvement in visual acuity
- Better visual rehabilitation and improves vision with contact lenses and glasses by normalizing the corneal surface and reducing irregular astigmatism.
- Refraction remains stable for years.
- If the refraction is small enough, the total refractive error may be reduced
- Patients are easier to fit with contact lenses, which are also better tolerated than before.
- Increased functionality and eliminated need for corneal grafting or transplant are also benefits of the combined treatment. Combining C3R treatment with a topography-guided treatment leads to better visual rehabilitation and improves vision by normalizing the corneal surface and reducing irregular astigmatism. A topography-guided surface treatment is followed by C3-riboflavin treatment.
- We perform this topography-guided laser + C3R with epi-off. There is sometimes a mild initial post procedure haze, but it resolves with treatment.
- Safety Issues
- Recently, safety issues have been resolved and confirm that the endothelium, lens, and retina are not involved in any potential or real damage after the treatment.
