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. 

Continue reading here.

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. 

Continue reading here.