Corneal Collagen Cross Linking with Riboflavin (also known as CXL, CCR, CCL, C3-R and KXL), is an addition to the normal LASIK procedure, designed to minimize the weakening effects of LASIK on the cornea and strengthen its structure. The cornea is the clear dome shaped window in the front of the eye.
Keratoconus (Cone shaped Bulging of the Cornea)
Pellucid Marginal Degeneration (Thinning in the peripheral region of the cornea)
Current Lasik patients who have higher powers or thinner corneas
Patients who have undergone Lasik in the past and are suffering from weakness of the cornea (called ectasia)
Patients with thinner than normal or irregular corneas who want to prevent Keratoconus or Pellucid Marginal Degeneration
Initially, a Lasik flap is created using a microkeratome (blade) or femtosecond laser (bladeless).
The flap is lifted and the laser is applied to the eye.
Riboflavin (Vitamin B2) is applied to the corneal bed and allowed to diffuse for a few seconds. The Riboflavin then penetrates the corneal stroma (the middle layer of the cornea). The excess solution is then washed off the cornea, the flap is replaced and the Riboflavin diffuses into this.
The Riboflavin is then exposed to UV light to facilitate cross linking for 90 seconds.
The chemical bonds in one's cornea are strengthened by this application of Vitamin B2 (Riboflavin) followed by treatment with UV Light.
What are the complications of
Risk of infections or possible endothelial cell is damage if corneal stromal bed is thinner than recommended
Chances of severe Diffuse Lamellar Keratitis (diffuse white, granular infiltrate occurring within a few days after LASIK)
Risk of corneal scarring
1. What are the advantages of Lasik Xtra over the conventional Lasik?
Allows the treatment of patients with thinner corneas or higher powers
Avoids the risk of post Lasik ectasia
Halts the progress of thinning or change in curvature of one's cornea as seen in Keratoconus
Reduces the chances of regression
2. How long do the effects last?
Over a decade of results have shown that cross-linking appears to last for a long time and there is evidence that the strengthening effect will be permanent.
3. Will this treatment cause my surgery
time to be prolonged too much?
This new technique reduces the time required for cross linking drastically from 1 hour (as seen with earlier techniques) to 2-3 minutes.
4. Does this mean I will be having two surgeries?
Lasik Xtra poses no material interruption to the normal speed and flow of the Lasik procedure and does not increase patient discomfort.
5. Does treatment with Riboflavin cause
any reduction in accuracy of Lasik?
Studies have shown that cross-linking treatment does not affect the accuracy of the excimer laser in correcting spectacle power.