Meeting News Coverage

Accelerated corneal cross-linking increases patient safety, speaker says

NEW ORLEANS — Corneal cross-linking performed at a higher wattage for a shorter period of time produces identical results and may increase safety due to the abbreviated exposure for the patient, a speaker reported here.

“While 3 mW/cm2 for 30 minutes won’t damage anything, it turns out that 3 mW/cm2 is the same as 30 mW/cm2, and it’s safe,” John Marshall, PhD, said at Refractive Surgery Subspecialty Day, which was jointly sponsored by the American Academy of Ophthalmology and the International Society of Refractive Surgery. “The shorter the exposure, the safer it is. Results are identical with this accelerated wattage.

John Marshall

“We know that LASIK weakens the cornea; the deeper the cut, the weaker the system,” he said. “But the question is: Could we perform corneal cross-linking after LASIK?”

Marshall said the chemistry is better understood today, with riboflavin serving as the active element.

“We can stimulate it by pulsing the oxygen and pulsing the light,” he said. “We can go to 90 mW/cm2 safely.

“If you just cross-link the center of the cornea, it makes the cornea flat,” Marshall said. “If you cross-link the periphery and change the fulcrum of the system, you’ll get central bulging of the cornea and address hyperopia. This is going to be the future of refractive surgery, with no pain and no biomechanical change.”

Disclosure: Marshall disclosed interests in Accelerated Vision, Avedro, Ellex, Nexis Vision, Optos and Schwind.

NEW ORLEANS — Corneal cross-linking performed at a higher wattage for a shorter period of time produces identical results and may increase safety due to the abbreviated exposure for the patient, a speaker reported here.

“While 3 mW/cm2 for 30 minutes won’t damage anything, it turns out that 3 mW/cm2 is the same as 30 mW/cm2, and it’s safe,” John Marshall, PhD, said at Refractive Surgery Subspecialty Day, which was jointly sponsored by the American Academy of Ophthalmology and the International Society of Refractive Surgery. “The shorter the exposure, the safer it is. Results are identical with this accelerated wattage.

John Marshall

“We know that LASIK weakens the cornea; the deeper the cut, the weaker the system,” he said. “But the question is: Could we perform corneal cross-linking after LASIK?”

Marshall said the chemistry is better understood today, with riboflavin serving as the active element.

“We can stimulate it by pulsing the oxygen and pulsing the light,” he said. “We can go to 90 mW/cm2 safely.

“If you just cross-link the center of the cornea, it makes the cornea flat,” Marshall said. “If you cross-link the periphery and change the fulcrum of the system, you’ll get central bulging of the cornea and address hyperopia. This is going to be the future of refractive surgery, with no pain and no biomechanical change.”

Disclosure: Marshall disclosed interests in Accelerated Vision, Avedro, Ellex, Nexis Vision, Optos and Schwind.

    See more from American Academy of Ophthalmology Meeting