How is Epithelium Off Corneal Cross Linking with Riboflavin performed

CXL or Cornea Cross Linking

CXL or Cornea Cross Linking

This procedure had been derived from the chemical industry. Cross linking has been used extensively in the plastic industry to strengthen materials. Polyester is an example.

The other names for this procedure are corneal collagen cross-linking, cross linking surgery, cross corneal linking, cross linking corneale, corneal cross linking and C3R. Different scientists and clinicians work to treat keratoconus. They have come up with different terms to describe their treatment methods.

‘A rose by any other name would smell as sweet’ wrote Shakespeare in Romeo and Juliet. Whatever the nomenclature for cornea cross linking, it has been a great advance in the treatment of keratoconus. This intervention stiffens and strengthens the cornea of a patient suffering from Keratoconus. Therefore it delays the progressive bulging of the cornea. Keratoconus eye disease is most active in the teen years. Corneal cross linking intervention in this phase of life has the maximum effect. Actively worsening disease is most amenable to treatment with  cornea collagen cross linkage. Conversely when the disease slows down the effectiveness of the treatment decreases. It is not even usually recommended for people above fifty years of age.

It is heartbreaking to see a kid suffer from this potentially blinding disease. They are afraid and so are the parents. Its therefore important to develop a good rapport with the young adult. The treatment is not short like lasik eye surgery. It takes anywhere between twenty to forty minutes. The healing is slow and visual recovery takes weeks. But its all worth it for this treatment method delays or halts the progression of keratoconus.  To have a deeper understanding of the mechanism of action of cxl, we need to revise the pathology of keratoconus.

There are a few variations of cross linking corneal.  Eli on, Epi off and Channel method.As with any new technique it is important that the protocol and results of the procedure be monitored by an independent agency. Confidence in cross linking procedure are if the results are presented for peer review and published. Till date no study has shown any technique to be better than epi off corneal collagen cross linking with riboflavin.