Transepithelial Crosslinking

Mona Fathy Mahmoud Sukkar


A s surgeons’ knowledge of CXL has increased and the indications for its use have widened, various modifications have emerged. Current modifications include the use of CXL without epithelial removal, variations on (UVA) fluence and duration, and the combination of CXL with procedures aimed at optical improvement and visual rehabilitation. There is an international controversy about if we remove or not remove the epithelium. Some researchers are in favor of leaving the epithelium intact in order to achieve faster visual rehabilitation and diminish of symptoms.Studies have demonstrated that is possible to improve epithelial permeability to riboflavin- 5-phosphate by modifying the standard riboflavin formulation. The current understanding of the photochemical kinetics of cross-linking suggests that the increased availability of oxygen obtained during the dark period may result in generation of more of the radicals that create cross-linking than are generated with an equivalent dose of continuous wave UVA. Varying the relative lengths of the light and dark phase influences efficiency of the process. Laboratory work demonstrates that shorter light phases result in enhanced availability of oxygen for dark phase chemistry and therefore greater cross-linking.

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Other Titles تثبيت القرنية من خلال النسيج الطلائي
Issue Date 2015

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