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Transcript 
Corneal collagen
cross-linking
(CXL)
ALIREZA PEYMAN, MD
ISFAHAN UNIVERSITY OF MEDICAL SCIENCES
http://www.drpeyman.ir
CXL with riboflavin and ultraviolet-A
irradiation introduced in 1998
Spoerl E, Huhle M, Seiler T. Induction of cross-links in corneal tissue. Exp Eye Res.
1998;66:97–103.
http://www.drpeyman.ir
Indications
 Cornea
ectasias
KC
PMD
 Iatrogenic
Post-LASIK
ectasias
keratectasia
 Infectious
ulcers
 Corneal edema
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Importance of age of the patient





<10 years old
10-20 years
20-30
30-40
>40





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Technique
 Using
a wavelength of 370 nm with
an accumulated irradiance of 5.4
J/cm2 ensures that the exposure of all
structures is below harmful levels
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 Epi-Off
 Epi-On
Penetration of riboflavin
Role of oxygen
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Irradiation
 Conventional
 Accelerated
 Pulsed
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Complications
 Significant
haze
 CTK
 Infection
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Combinations
 CXL
+ ICRS
 CXL + Microwave keratoplasty
(Keraflex)
 CXL
+ PRK
 CXL + LASIK
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Is repeat CXL helpful?
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