Corneal Crosslinking

In April 2016, the FDA approved Avedro's corneal collagen cross-linking platform along with two Riboflavin (Vitamin B2) photoenhancers for the treatment of progressive keratoconus. In July 2016, the FDA also approved the treatment of corneal ectasia following refractive surgery.
UVA/riboflavin corneal collagen cross-linking was first used to treat patients in 1998 in Dresden, Germany. Data has shown that this treatment may slow or stop the progression of keratoconus and corneal ectasia, and the majority of patients have had a lasting effect (no progression) 3-5 years after their initial treatment.

In our last FDA study with Avedro, we were able to offer shorter treatment time epithelium-off crosslinking treatments which will now be available to patients outside of the study. In addition, we are able to do epithelium-on (trans-epithelial) treatment based on the original Dresden protocol. This should allow for faster healing time, return to contact lens wear sooner, and less risk of infection and corneal scarring. 

Q: What is Collagen Crosslinking (CXL)?

A: It is a treatment that uses Riboflavin and UV light applied in an office-based setting to strengthen the cornea by increasing crosslinking bonds between collagen fibrils.  Originally developed in Germany, CXL has been investigated extensively and has been shown clinically to arrest the progression of keratoconus and post-LASIK ectasia. Although not a cure, treatment can slow or stop the progression of disease, thus allowing many patients to avoid or delay corneal transplantation.
Q: Who is a candidate?
A: We are able to treat Keratoconus, Pellucid Marginal Degeneration, and Post-Refractive Ectasia (including Radial Keratotomy) in patients aged 14 and older. Pregnant patients, those with history of HSV, and those without a UV blocking lens implant are excluded. In our epi-on study, we are also able to treat patients aged 12 and older and we also have the separate ability to treat patients with corneal ulcers (bacterial, fungal and amoebae) who have failed standard medical therapy. 


See our brochure for more information on Corneal Cross-linking.


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Mid Atlantic Cornea Consultants
Sudeep Pramanik MD MBA FACS

Towson, Maryland Ophthalmologist, Dr. Sudeep Pramanik is dedicated to excellence in ophthalmology such as referrals for complex surgery, management of cornea and anterior eye disease, and laser refractive surgery.

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