CORNEAL COLLAGEN CROSSLINKING WITH RIBOFLAVIN (C3R)
The latest revolutionary Keratoconus treatment is C3R (Corneal Collagen Crosslinking with Riboflavin) that has been proven to strengthen the weak corneal structure by increasing collagen crosslinking, which are the natural “anchors” within the cornea. These anchors are responsible for preventing the cornea from bulging out and becoming steep and irregular, consequence of advanced Keratoconus. C3R causes the collagen fibrils to thicken, stiffen, and crosslink & reattach to each other, making the cornea stronger and more stable & halting the progression of the disease. The Procedure The C3R treatment is performed in 30 minutes. During the treatment, custom-made riboflavin eye drops are applied to the cornea, which is then activated by ultraviolet light The cornea which is the front transparent structure of the eye is first anaesthetized using drops. . The mucous surface of the cornea (epithelium) is disrupted and then Riboflavin, (Vitamin B2) drops are placed in the eye every few minutes. The yellow pigment of the Riboflavin absorbs the Ultraviolet A light , increases the amount of collagen cross-linking in the cornea and strengthen the cornea. Once the procedure is completed, a soft bandage contact lens will be placed in the eye and antibiotics will be instilled. The contact lens will be removed in one or two days. The cornea increases in rigidity soon after the procedure although the process of cross linking continues on for a period of a few days afterwards. During X-linking new chemical bonds are induced .
Is Ultraviolet light harmful ?
Ultraviolet A light used in this procedure is not harmful to the eye in measured doses. Ultraviolet C light (in sunlight) is potentially harmful. The Light emitting diodes used in the C3R device is of a wavelength that is not harmful. Furthermore, light emission is carefully measured and calibrated prior to each treatment. There is also a self diagnostic check on the device which prevents use in case of a malfunction. There have been concerns about toxicity to the retina (at the back of the eye) however the Riboflavin pigment in the cornea and front of the eye, absorbs the Ultraviolet light and in effect stops the light from being transmitted to the retina.We have the protective device which tells that your eyes are getting constant wavelength & energy, which is must for these UV A delivering devices, as different wavelength , low or high energy delivered to eye can harm your eyes.
Advantages of C3R |CORNEAL COLLAGEN CROSSLINKING
- Simple non invasive treatment
- Halts the progress as new chemical bonds are induced and causes some regression
- No handling of lenses every day
- No stitches
- No incisions
- Quick recovery
Contact Lenses – RGP Contact LensesIn mild or early stages, eyeglasses or normal contact lenses may correct the astigmatic vision. Contact lenses in Keratoconus are not easy to fit, usually not very comfortable. They need constant maintenance and frequent follow ups with the doctor. As Keratoconus advances, rigid gas-permeable (RGP) contact lenses maybe the only non-surgical way to achieve clear vision. But contact lens fitting of a patient with Keratoconus requires much care and frequent check-ups, because the condition can worsen. Most importantly, they do not arrest the progress of disease. Also there can be scarring as a result of contact lens wear causes problems of its own.
Intacs It is insertion of intrastromal corneal ring segments. A small incision is made in the periphery of the cornea and two thin arcs of polymethyl methacrylate slide between the layers of the corneal stroma on either side of the pupil, the incision then being closed. The segments push out against the curvature of the cornea, flattening the peak of the cone and returning it to a more natural shape. However intacs do not inherently alter the biomechanical structural integrity of the cornea and thus may not be a permanent solution. If the refraction changes over a period of time after inserting the intacs rings they would need to be removed. It is not recommended at our centre due to its high complications worldwide.
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