Cornea/External Disease

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Publication Exclusive: Contact lens-assisted cross-linking treats corneal ectatic disorders in thin corneas

February 13, 2016

Collagen fibers in the human body are normally bonded together and stabilized by covalent cross-links. The tensile strength of mature collagen fibers is largely due to intermolecular covalent cross-links. Collagen cross-linking was described by Theo Seiler et al as a means to strengthen a weak and ectatic cornea. This works by utilizing ultraviolet A at a wavelength of 370 nm in the presence of the photosensitizer riboflavin to create an increased number of covalent bonds among corneal stromal collagen fibers.

Riboflavin is a photosensitizer and causes damage at a lower UVA irradiance level of 0.36 mW/cm2. The creation of oxygen free radicals leads to induction of collagen cross-links, which in turn leads to more compact interlamellar connections. Riboflavin also has an additional protective role by increasing the absorption coefficient, thereby decreasing final irradiance at the endothelial level down to 0.18 mW/cm2. However, 400 µm of riboflavin-saturated stroma above the endothelium is considered safe to avoid adverse effects. In patients with corneas thinner than this, conventional cross-linking cannot be performed. For patients with corneal stromal thickness between 350 µm to 400 µm after epithelial removal, we have performed a new technique called contact lens-assisted cross-linking (CACXL). This was described by Soosan Jacob.

In the Journals

Short-term scleral lens wear improves some signs of dry eye

February 9, 2016
Osmolarity and diadenosine tetraphosphate improved in patients with keratoconus after 8 hours of scleral contact lens wear, according to researchers in Optometry and
From OSN Europe

Publication Exclusive: Dry eye a common but still often overlooked condition

February 9, 2016
Dry eye is a problem that every ophthalmologist faces on a daily basis. It is one of the most frequent causes for patients to visit the ophthalmologist. Dry eye is a…
Meeting News CoverageVideo

VIDEO: Cornea specialist emphasizes importance of optimizing ocular surface before cataract surgery

February 7, 2016
WAIKOLOA, Hawaii — At Hawaiian Eye, Kenneth A. Beckman, MD, FACS, gives reasons why surgeons should ensure a healthy ocular surface before cataract surgery: to ensure…
From OSN APAO

Publication Exclusive: Contact lens-assisted cross-linking treats corneal ectatic disorders in thin corneas

February 13, 2016
Collagen fibers in the human body are normally bonded together and stabilized by covalent cross-links. The tensile strength of mature collagen fibers…
In the Journals

Short-term scleral lens wear improves some signs of dry eye

February 9, 2016
Osmolarity and diadenosine tetraphosphate improved in patients with keratoconus after 8 hours of scleral contact lens wear, according to researchers…
From OSN Europe

Publication Exclusive: Dry eye a common but still often overlooked condition

February 9, 2016
Dry eye is a problem that every ophthalmologist faces on a daily basis. It is one of the most frequent causes for patients to visit the…
Meeting News CoverageVideo

VIDEO: Cornea specialist emphasizes importance of optimizing ocular surface before cataract surgery

February 7, 2016
WAIKOLOA, Hawaii — At Hawaiian Eye, Kenneth A. Beckman, MD, FACS, gives reasons why surgeons should ensure a healthy ocular surface before cataract…
Meeting News CoverageVideo

VIDEO: Surgeon gives update on uses for amniotic membrane

February 6, 2016
WAIKOLOA, Hawaii — At Hawaiian Eye, Roxana Ursea, MD, discusses the applications for amniotic membrane in treatment of ocular surface diseases…
Business News

Nicox, Ora enter into licensing agreement for AC-120 for morning eyelid swelling

February 5, 2016
Nicox has entered into a licensing agreement that grants Ora exclusive worldwide rights for the development and commercialization of Nicox’s…
Meeting News CoverageVideo

VIDEO: Surgeon discusses advantages of standard operating protocol for managing dry eye disease

February 4, 2016
WAIKOLOA, Hawaii — At Hawaiian Eye, Elizabeth Yeu, MD, discusses how implementing a standard protocol for assessing new cases of dry eye disease has…

Chickenpox, shingles vaccine associated with corneal inflammation

February 4, 2016
Analysis of case reports identified an association between the varicella zoster vaccine and keratitis in both children and adults, according to…
Breaking News

Ophthalmic community loses surgeon, educator with passing of Kenneth A. Greenberg, MD

February 4, 2016
Ophthalmic surgeon and educator Kenneth A. Greenberg, MD, died Jan. 31.Greenberg practiced for 25 years in Danbury and Ridgefield, Conn., and…
Meeting News CoverageVideo

VIDEO: Surgeon anticipates FDA approval of collagen cross-linking for treatment of keratoconus, ectasia

February 2, 2016
WAIKOLOA, Hawaii — At Hawaiian Eye, Rajesh K. Rajpal, MD, discusses positive results from multiple studies on collagen cross-linking for the…
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