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Collagen cross-linking may offer hope for corneal ectasia, keratoconus
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KIAWAH ISLAND, S.C. — An effective treatment for corneal ectasia and keratoconus has long eluded ophthalmologists, but a novel therapeutic approach using collagen cross-linking may offer promise, according to a surgeon speaking here.
In the procedure, riboflavin is introduced to the eye after epithelium removal, followed by exposure to an ultraviolet light source, Eric D. Donnenfeld, MD, said at Kiawah Eye 2009. The riboflavin creates free radicals that are later stiffened by the ultraviolet light. As a result, the combined procedure strengthens the biomechanical properties of the cornea and increases the tensile strength, eventually leading to a slight flattening of the cornea.
"You don't get an immediate flattening of the cornea. It happens over the course of 2 to 3 months," he said.
Dr. Donnenfeld is a principal investigator on a multicenter, crossover study that will prospectively follow 160 patients. The trial is still enrolling, but Dr. Donnenfeld said he has seen promising results in about 40 patients he has treated with the procedure so far.
The novel therapeutic approach could be a boon to keratoconus management and could be considered primary therapy in patients with enough corneal thickness. As well, Dr. Donnenfeld said, the treatment has theoretical applications beyond keratoconus, including recalcitrant corneal infections and bullous keratoplasty.
Kiawah Eye 2010 will be held May 13-15, 2010 at the Kiawah Island Golf Resort in South Carolina. Learn more at KiawahEye.com.