TREATMENT OF KERATOCONUS WITH CORNEAL CROSSLINKING (CCL) USING RIBOFLAVIN (B2 BRIDGING). This treatment method strengthens collagen fibre bonds in cornea with the application of ultraviolet radiation (UVA 365 nm) and riboflavin (Vitamin B2) photosensitive agent.

In addition to corneal strengthening it is possible to beforehand correct the vision disorder caused by changes to the corneal shape. This procedure is called COMBINED CORNEAL CORRECTION, LASER+CCL (PTK+T-CAT PRK+CCL). The procedure is a correction of corneal surface with an excimer laser after which vitamin B2 bridging is performed immediately. The procedure is usually performed in one eye; the other eye will not be operated before 6 weeks has elapsed from the surgery of the first eye.

Description of the procedure
Treatment takes place in operating room in sterile conditions under local anaesthesia (cornea will be anaesthetised with eye drops). During the operation the cells on the surface of the cornea (epithelium) will be removed mechanically, thereafter riboflavin drops are instilled on the surface of the cornea for 30 minutes. Then riboflavin is activated with ultraviolet light for another 30 minutes. After treatment contact lens is inserted into the eye. After the procedure the patient has to use at home antibacterial eye drops prescribed by the ophthalmologist until the removal of contact lens. Further treatment will be according to the regimen prescribed by the ophthalmologist.

Treatment results
Crosslinking treatment (B2 bridging) does not cure keratoconus; this procedure slows or halts the progression of the disease. In most of the cases patients can use eyeglasses or contact lenses again for the correction of their visual acuity after this treatment. On some occasions it is possible to perform laser correction with excimer laser or insert additional lens into the eye after crosslinking procedure in order to free the patient from the need of wearing eyeglasses or contact lenses.

Possible complications of the procedure

  • post-procedural inconvenience: light sensitivity, feeling of sand or foreign body in the eye, which usually disappear within a few days;
  • corneal haziness after the procedure that could need correction with corticosteroid eye drops;
  • eye inflammation after the procedure.

NB! Since CCL procedure is included in the list of healthcare services of the Estonian Health Insurance Fund. The operations are performed by a surgeon Kai Noor.