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Corneal collagen cross-linking (CXL)

Corneal collagen cross-linking (CXL). Alireza Peyman, MD Isfahan University of Medical Sciences. CXL with riboflavin and ultraviolet-A irradiation introduced in 1998 Spoerl E, Huhle M, Seiler T. Induction of cross-links in corneal tissue. Exp Eye Res. 1998;66:97–103. Indications.

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Corneal collagen cross-linking (CXL)

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  1. Corneal collagen cross-linking(CXL) Alireza Peyman, MD Isfahan University of Medical Sciences

  2. CXL with riboflavin and ultraviolet-A irradiation introduced in 1998 Spoerl E, Huhle M, Seiler T. Induction of cross-links in corneal tissue. Exp Eye Res. 1998;66:97–103.

  3. Indications • Cornea ectasias • KC • PMD • Iatrogenic ectasias • Post-LASIK keratectasia • Infectious ulcers • Corneal edema

  4. Importance of age of the patient • <10 years old   • 10-20 years  • 20-30  • 30-40  • >40 

  5. Technique • Using a wavelength of 370 nm with an accumulated irradiance of 5.4 J/cm2 ensures that the exposure of all structures is below harmful levels

  6. Epi-Off • Epi-On Penetration of riboflavin Role of oxygen

  7. Irradiation • Conventional • Accelerated • Pulsed

  8. Complications • Significant haze • CTK • Infection

  9. Combinations • CXL + ICRS • CXL + Microwave keratoplasty (Keraflex) • CXL + PRK • CXL + LASIK

  10. Is repeat CXL helpful?

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