Cross-Linking

Cross linking of cornea or crosslinkage is the latest treatment in the fight against the corneal disease of keratoconus. As you may remember keratoconus disease is a weakening and thinning of cornea leading to protusion forward. The goal of crosslinking is to strenghen this fragile cornea. this is achieved by increasing the bonds between the layers of cornea. The bonds link the fibres of cornea and hence the term cross linkage. To illustrate this point lets consider an example. Let us suppose there is a cage with parrallel bars with butterflies inside. It is easy for the butterflies to flutter out between the bars. Now, suppose we run multiple layers of wires perpendicular to the bars. The butterflies will find it next to imposssible to fly away. This concept vividly explains what is achieved by cross linkage.
The parallel layers or lamellae of the cornea can be pushed by ine internal pressure of the eye. By adding crossslinkage the layers act as one unit and are able to resist the internal pressure of the eye. The idea of crosslinkage was adopted from the polymer industry. The chemical engineers routinely use crosslinking with covalent bonds to strenghen substances and develop new ones. Plastic is an example. The idea was adopted into ophthalmology and various chemicals and techniques were experimented with.

Currently, riboflavin is the chemical of choice. The riboflavin is applied either with epithelium on or epithelium removed. Riboflavin is activated by UVA light. This causes riboflavin to relase nascent oxygen radicals.This oxygen particles form bonds which are called crosslinks. It is important to note that Riboflavin also protects deeper parts of the cornea and the eye from the harmful effects of the Ultraviolet radiation. A contact lens is applied and patient instills drops for next several days.

Cornea Cross linking is the new treatment for keratoconus. Please feel to read our Keratoconus blog for more research results.

If you or your relative suffer from keratoconus and want to know if you are a good candidate for cornea cross linkage feel free to ask our cornea keratoconus expert on cross linkage. Even if you live in Arizona Washington or Utah our passionate keratoconus surgeon can help you. Read how we make cornea cross linking affordable.

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