Surgery : Anterior Segment : Crosslinking

Treatment that enhaces the cornea's biomechanical force (rigidity ) , reinforcing corneal structure, generating new colagen bridges and decreasing the posibility of thinning and deformation of the cornea. It consists of the application of topical anesthesia (drops), the strippage of the corneal epithelium, application of Riboflavin ( vitamin B2) drops for 30 minutes until the cornea is soaked. Riboflavine will sensitize the stroma and a 365 nm ultra violet (UV) light is then applied for 5 minutes.

A contact lens is placed for 7 days; antibiotics, antiinflammatory agents and lubricating drops are prescribed. The patient is examined the next day. For a few days the patient will feel a burning, foreign body sensation, light sensitivity and tearing. This is normal.

It is important to know that this procedure is therapeutic ,not prescription corrective. So the patient will not see any improvement in his/her vision. The purpose of this treatment is to avoid the thinning and deformity of the cornea.

It is indicated in:

Corneal ectasias ( corneal deformities) in Keratoconus and Marginal Pelucid Degeneration. It stops the further development of these conditions.
Treatment of corneal ectasias after refractive surgery with excimer laser. It stop the development of the ectasia
Prevention of corneal ectasias immediatelly after refractive surgery. Prevents thinning and deformity of the cornea
Fungal queratitis. UV light kills fungus.

The complications are very rare, but can include:

Corneal Haze : corneal opacity due to an anomalous healing .(Depends on the patient´s scarring).
Corneal infection , must be treated with topical antibiotics.
Persistent epithelial defects.

Few occasions will ectasia continue its course and a new crosslinking procedure may be indicated among other treatments such as intracorneal ring segment implantation or corneal transplants.

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