Collagen-crosslinking

Collagen-crosslinking

Corneal crosslinking is an efficient micro-invasive method used in ophthalmology mainly for treatment of keratoconus and some other diseases. Idea of conservative keratoconus treatment was born in Germany among researchers of Dresden Technical University. T. Seiler and G. Wollensak based their method on the principle of photopolymerization, which was already used in stomatology (“light filling”). Series of works resulted in the most efficient and safe technique of corneal collagen crosslinking, based on photopolymerization of stromal fibers under influence of photo mediator (riboflavin solution) and small doses of ultra violet radiance by solid state source/ This technique allows to stop the progression of keratoconus and to avoid the penetrating keratoplasty.

• Keratoconus of I-II stage
• Corneal ectasia after refractive excimer surgeries and radial keratotomy
• Marginal corneal degeneration
• Keratoglobus
• Bullous keratopathy I-II stages
• There are positive results of collagen-crosslinking treatment in cases of keratitis and corneal ulcer

• Riboflavin intolerance (Vitamin В2)
• If cornea thickness is less than 400 mcm in any of dimensions
• Low visual acuity with correction in case of keratoconus in spite of sufficient thickness
• Allergic conjunctivitis present

Corneal crosslinking procedure is performed under local eye drop anesthesia. The upper corneal layer is removed for better penetration of riboflavin solution into the thickness of cornea. Riboflavin solution is continuously dropped into the eye for 20-30 minutes, and cornea tissue is evenly soaked with it. After this doctor performs intraoperative pachymetry and estimates if cornea is sufficiently saturated. In case it is enough saturated with riboflavin, cornea is exposed to ultraviolet for 10 minutes. Ultraviolet radiation level is not very high and doesn’t damage eye tissues which are situated deeper.

At the end of the procedure antibacterial drops are applied and a healing soft lens is put on the operated eye. When wearing the soft lens, (usually it takes 3 days) patient should use antibacterial eye drops, and after it is removed – patient should use anti-inflammatory medicines. In average it takes 4-5 day time for superficial layers of cornea to recover after cross-linking, and visual acuity is recovered in 3 month time. Operating room of St. Petersburg Branch is equipped with Russian UV-radiation sources “Ufalink” and special set for corneal phototherapy.