A Glimpse into the Future

By George O. Waring IV, MD

Senior Editor, Refractive Surgery

This inaugural edition of the Refractive Surgery Section of Pearls in Ophthalmology will discuss collagen crosslinking (CXL) for the treatment of keratoectasia. Until recently, treatment options for keratoectasia were limited to rigid contact lenses, Intacs intracorneal segments, and corneal transplantation. CXL is a promising technology that will allow surgeons to biomechanically strengthen progressively weakening corneas. Studies have demonstrated not only refractive stability, but refractive improvement after treatment [1]. Combination therapy with Intacs intracorneal segments and conductive keratoplasty are being used synergistically and allow for refined refractive outcomes [2]. New methods, materials and applications for corneal strengthening are currently being evaluated and will be discussed in this section. In the future, refractive surgeons may strengthen corneas prior to corneal refractive procedures in eyes at risk for development of keratoectasia, if not all patients.

References

1. Wollensak G, Spoerl E, Seiler T. Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus. Am J Ophthalmol. 2003; 135:620-627.

2. Chan CC, Sharma M, Wachler BS. Effect of inferior-segment Intacs with and without C3-R on keratoconus. J Cataract Refract Surg. 2007 Jan;33(1):75-80.