Cross-linking round table, part 2: Epi-on vs. epi-off and measures of success
At the 2013 European Society of Cataract and Refractive Surgeons meeting, Ocular Surgery News convened a round table of international experts to discuss the current state of corneal cross-linking. The second part of that wide-ranging discussion, moderated by Roy S. Rubinfeld, MD, is featured in the Feb. 25 issue of OSN.
Roy S. Rubinfeld, MD: Let’s talk about epi-on vs. epi-off in terms of safety. At this conference, there are numerous abstracts and presentations showing some proprietary new epi-on cross-linking techniques to have efficacy similar to older epi-off techniques, but when there is a complication, say after a perforation, after epi-off, it is simply not pretty.
William B. Trattler, MD: I spoke to a surgeon who shared the details of a serious complication with epi-off cross-linking that occurred in Australia, which appears to be a complication from a compounding pharmacy that used the wrong riboflavin formulation. It was not related to the UV light but rather due to an improper formulation of the riboflavin formulation.
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