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Experts debate corneal collagen cross-linking methods
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SAN FRANCISCO — The best practices to follow during corneal collagen cross-linking have yet to be determined, but the procedure has numerous benefits, a panel of experts said here.
“While there are controversies, all studies and early users agree that CXL halts the progression of ectatic disorders and usually causes some degree of regression of the disease,” John A. Hovanesian, MD, FACS, said during the Update on Corneal Collagen Cross-linking panel sponsored by the American Society of Cataract and Refractive Surgery’s cornea and refractive surgery committees during the ASCRS meeting.
One area of disagreement was performing the procedure with the epithelium off or on.
William B. Trattler, MD, said that epithelium-on cross-linking, in which the procedure is performed through intact epithelium, achieves identical results to epithelium-off treatments, as long as adequate penetration of riboflavin in the cornea is accomplished.
A. John Kanellopoulos, MD, said that while epithelium-on treatments can be performed, the riboflavin is best delivered through a corneal pocket created by a femtosecond laser.
Disclosures: Hovanesian is a consultant with Abbott Medical Optics, Bausch + Lomb, Calhoun Vision, Clarity Medical Systems, Essex Woodlands Health Ventures, Fera Pharmaceuticals, Glaukos, Inspire Pharmaceuticals, IOP, Ista Pharmaceuticals, Ivantis, Ocular Therapeutix, ReVision Optics, SARcode Biosciences, Sarentis Ophthalmics, Sight Sciences and TearScience. Kanellopoulos is a consultant with Alcon and WaveLight Laser Technologies. Trattler is a consultant with Abbott Medical Optics, Allergan, Bausch + Lomb, CXLUSA, Ferrara Ophthalmics, LensAR, Lenstec and Oculus; has research funded by Bausch + Lomb and Hoya Vision Care; and has travel expenses paid by Abbott Medical Optics.