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Riboflavin UV cross-linking useful for more indications
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CHICAGO — Riboflavin ultraviolet cross-linking has a growing number of indications, including prophylaxis in LASIK and PRK and treating infectious keratitis and bullous keratopathy, a speaker said here.
“Not every infection responds to conventional medical therapy,” Eric D. Donnenfeld, MD, OSN Corneal/External Disease Board Member, said at the joint meeting of the American Academy of Ophthalmology and Asia-Pacific Academy of Ophthalmology. “[Riboflavin UV cross-linking] can potentially be useful with opportunistic infections that do not respond to conventional treatment.”
Donnenfeld said UV exposure and riboflavin concentration may be useful in treating infectious keratitis by sterilizing the stroma in patients who are not responsive to conventional treatment.
Concerns with riboflavin UV cross-linking in keratitis include the potential of endothelial toxicity, the potential for limbal cell and/or goblet cell toxicity, and unknown risks associated with the apoptosis of keratocytes, he said.
A significant improvement in visual acuity is observed when combining riboflavin UV cross-linking with topographic PRK following post-LASIK ectasia and keratoconus, according to Donnenfeld.
However, he said concerns associated with combination PRK and riboflavin UV cross-linking include the potential for endothelial and limbal cell toxicity, as well as the addition of a refractive variable to the procedure due to corneal flattening associated with riboflavin UV cross-linking.
“Riboflavin UV cross-linking may be useful for the stabilization of ectatic cornea, the pretreatment of eyes at risk for ectasia, the stabilization of radial keratotomy eyes, the treatment of sterile corneal ulceration, and the treatment of corneal edema,” Donnenfeld said.
Disclosure: Donnenfeld has no relevant financial disclosures.