| Collagen Cross-Linking (CCL) using Riboflavin and UV (365nm) exposure Also known as C3R or CXL |
| Keratoconus is a disorder of the cornea characterized by progressive thinning and ectasia which results in deterioration of the quality of vision and also the quality of life. As the disease begins in young adults, it affects the most productive years of life. So far there has been no effective way to stop the progression of keratoconus. Current methods such as rigid contact lens, & intracorneal ring segments only the refractive error can be corrected without any 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 modality of treatment, based on collagen crosslinking with the help of Ultraviolet A (UVA, 365nm) and the photosensitizer riboflavin phosphate has been described which 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. |
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| Collagen Crosslinking treatment Eligibility Criteria - Patients with progressive Keratoconus - Minimum corneal thickness of 400 microns - Maximal keratometry readings < 60 D - No other corneal disease - Patients over the age of 16 years |
| FREQUENTLY ASKED QUESTIONS What is collagen cross-linking? Collagen cross-linking is a new treatment for keratoconus, that uses a photosensitizing agent, riboflavin (vitamin B2) & ultraviolet light (UVA, 365nm) exposure. In extensive experimental studies (including biomechanical stress & strain measurements) researchers have demonstrated a significant increase in corneal rigidity / stiffness after collagen cross- linking using this riboflavin/UVA treatment. The 3 & 5 year results of Dresden clinical study in human eyes has shown arrest of progression of keratoconus in all treated eyes. (Wollensak G. Crosslinking treatment of progressive keratoconus: New Hope. Current Opinion in Ophthalmology 2006; 17: 356 – 360) How is the treatment done? The treatment is performed under topical anesthesia. The skin (epithelium) of the surface of the cornea is partially scratched, followed by application of Riboflavin eye drops for 30 minutes. The eye is then exposed to UVA light for 30 minutes. After the treatment, antibiotic ointment is applied and an eye-pad is worn overnight until the next day when the surface of the eye has healed. Oral analgesics are required for the first 1 -2 days Who can benefit from this treatment? Collagen cross-linking treatment is not a cure for keratoconus, Rather, it aims to halt the progression of the condition. This is important to understand. Patients will continue to wear spectacles or contact lenses (although a change in the prescription may be required) following the cross-linking treatment. The main aim of this treatment is to arrest progression of keratoconus, and thereby prevent further deterioration in vision and the need for corneal transplantation. However in advanced keratoconus, wherein the corneal thickness is below 350 microns, this treatment may not be possible. In such a situation other alternatives such as deep anterior lamellar keratoplasty (DALK) should be considered. |
Dr Rajesh Fogla, senior corneal surgeon has special interest in keratoconus disorder and its management. He has a vast experience in contact lens fitting, & specialized corneal procedures to effectively manage this condition. He has been performing Deep Anterior Lamellar Keratoplasty since 1998, & has numerous publications & presentations on the same For more information regarding the cost of surgery and other details you can email Dr Rajesh Fogla at dr_fogla@yahoo.com or call him on +91 9866076750 |
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| Cornea Clinic - Eye Department - Apollo Hospitals, Jubilee Hills, Hyderabad 500096, Telangana, INDIA |
| Cornea Clinic - toll free number 1600 345 1066, other numbers 91 40 23607777 ext 6333 |
| Tel 91 40 23607777, Fax 91 40 23608050 ,24 hours emergency services call 1066 |
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| Cornea Clinic |
| Center for Innovative Corneal Surgery |
| Collagen Crosslinking treatment Peschke CCL Vario UV device is used for the procedure at Cornea Clinic. Options for treatment include the standard 30 mins protocol using 3mW exposure, or 10 minutes protocol using the 9mW exposure. Accelerated crosslinking can also be performed in 5 minutes using 18mW exposure. Special riboflavin solutions are used for thinner cornea to swell them to appropriate thickness prior to the UVA exposure Safety has always been our priority ever since we started performing this procedure since 2005 |