This article is more than 5 years old. Information may no longer be current.
Classic method of cross-linking still obtains best results
Click Here to Manage Email Alerts
PARIS — Classic epithelium-off corneal collagen cross-linking still gives the best results compared with accelerated and transepithelial options of cross-linking, according to a study carried out in Bordeaux, France.
"With our protocol, a consistently higher reduction of K-max and astigmatism was obtained when using the classic method of cross-linking. Regression of keratoconus occurred in 33% of the cases, compared to 20% with accelerated CXL and 6% with transepithelial CXL," David Touboul, MD, said at the meeting of the French Society of Ophthalmology.
David Touboul
The different level of riboflavin absorption is crucial in explaining the results. With classic cross-linking and transepithelial cross-linking, a soaking time of 30 minutes was used, but the epithelium is a natural barrier to penetration.
"With the accelerated CXL protocol, we soak the cornea for only 15 minutes. It is still early days to draw conclusions about this technique, but probably we need to give more time for the riboflavin to penetrate the stroma," Touboul said.
Transepithelial cross-linking, he said, is not successful without an additional strategy, such as puncture or local abrasion. Iontophoresis might be the answer, and following the success of animal experiments, this new technique is being applied on patients within a study in Bordeaux and other centers in France.
Disclosure: Touboul has no relevant financial disclosures.