Keratoconus is a disorder of the cornea characterized by progressive thinning and ectasia which results in deterioration of the quality of vision and also affects the quality of life. As the disease begins in young adults, it affects the most productive years of life. The treatment of this disorder has only been optical rehabilitation with rigid contact lenses, epikeratoplasty, intracorneal ring segments or corneal transplant. None of these treatment modalities can halt the progression of keratoconus. In about 20% of keratoconus cases, progression may be to an extent that eventually surgical intervention in the form of corneal transplantation is required.

With the advent of Corneal Collagen Crosslinking with Riboflavin (C3R), there is hope for millions of keratoconus patients, because this treatment has been shown to arrest the progression of the disease. C3R involves the use of a photosensitizing agent, riboflavin (Vitamin B2) and ultraviolet light (UVA 365 nm) exposure. It induces crosslinkage of corneal collagen fibres at molecular level, thus changing the intrinsic biomechanical properties of cornea and strengthening the corneal architecture. It also helps in better contact lens fitting in these patients and reduces the need for major surgeries like corneal transplantation

In various studies (including biomechanical stress & strain measurements) researchers have demonstrated a significant increase in corneal rigidity after collagen cross-linking using this riboflavin/UVA treatment. The 3 & 5 year results of Dresden clinical study in human eyes has shown arrest of progression of keratoconus in all treated eyes. (Wollensak G. Crosslinking treatment of progressive keratoconus: New Hope. Current Opinion in Ophthalmology 2006; 17: 356 – 360)

The treatment is performed under topical anesthesia. The epithelium (outermost layer) on the surface of the cornea is partially scraped, followed by application of Riboflavin eye drops for 30 minutes. The eye is then exposed to UVA light for 30 minutes. After the treatment, a bandage contact lens is applied which is removed once the epithelium heals.There is no need to patch the eye.

Apart from keratoconus, C3R is also indicated to strengthen the cornea in other ectatic conditions like pellucid marginal degeneration, keratectasia following LASIK and cornea melting that is not responding to conventional therapy.

C3R should not be done if the corneal thickness is less than 400 microns, and in case of central corneal scarring. The main aim of this treatment is to arrest progression of keratoconus, and thereby prevent further deterioration in vision and the need for corneal transplantation. This treatment reduces the astigmatism (cylindrical power)  by a couple of diopters and improves the quality of vision, but patients will need to wear spectacles or contact lenses (although a change in the prescription may be required).

This treatment facility is available at Max Eye Care, S-347, Panchsheel Park, New Delhi.