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Optimized beam profile increases efficacy of corneal cross-linking
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WARSAW, Poland — The safety profile of corneal cross-linking has been confirmed through more than 15 years of follow-up, and continuous innovation has increased efficacy, according to a speaker.
Summarizing cross-linking results to date and current complication rates at the winter meeting of the European Society of Cataract and Refractive Surgeons, Theo Seiler, MD, PhD, said that 1% of eyes experience two lines of vision loss. Recognized risk factors are age older than 35 years and preoperative best corrected visual acuity greater than 20/25.
Theo Seiler
Delayed epithelial healing, occurring at a rate of 2%, is the only other complication that may present a challenge because of the risk of infection, he said. Keratoconus progression occurs in 3% of eyes, mainly those with advanced stage disease.
A progressive increase in treatment-induced corneal flattening is seen over time in most patients, according to Seiler.
“This constant decrease in [keratometry] readings, up to 7 D in some cases, came to us as a pleasant surprise,” he said.
The optimized beam profile of the new IROC UV-X 2000 illumination system (IROC Innocross) increases the efficacy of the procedure, Seiler said. The system is designed to increase the depth of cross-linking in the mid-periphery of the cornea, leading to a demarcation line that is equidistant to the corneal back surface.
“The new device enables us to increase the diameter of illumination and the cross-linked volume of the cornea. Flattening rate with the new machines is now nearly 100%, compared with 37% with the previous model. Two-thirds of cross-linked corneas now achieve a flattening of more than 2 D over 1 year,” he said.
Due to the significant flattening induced by the new procedure, combination treatment with PRK is better avoided, he said.
Disclosure: Seiler has no relevant financial disclosures.