Mucin layer removed with a soaked sponge without debriding the epithelium, then drops applied per protocol with the O2n System and Boost Goggles
Epithelium-ON: the epithelium stays, so recovery is faster and far less painful than the Photrexa protocol
Contraindications
Hypersensitivity Aphakic and pseudophakic patients without a UV-blocking intraocular lens.
Available Forms
Epioxa HD (riboflavin 5'-phosphate ophthalmic solution 0.239%) and Epioxa (0.177%), used with the O2n System and Boost Goggles.
Mechanism of Action
Riboflavin 5'-phosphate sodium (Vitamin B2) is the precursor of two coenzymes, flavin adenine dinucleotide and flavin mononucleotide, which catalyze oxidation/reduction reactions involved in a number of metabolic pathways. Under the conditions used for corneal collagen cross-linking, riboflavin 5'-phosphate functions as a photoenhancer and generates singlet oxygen which is responsible for the cross-linking.
Warnings & Precautions
Herpetic keratitis: use with caution in patients with a history of herpetic keratitis, because cross-linking may reactivate it.
Common Side Effects
The most common adverse reaction was conjunctival hyperaemia (31%).
Pregnancy & Lactation
Pregnancy: Animal development and reproduction studies have not been conducted; it is not known whether the procedure can cause fetal harm.
Lactation: Not stated on the FDA label.
Pediatric Use
The safety and effectiveness of EPIOXA HD and EPIOXA for the treatment of keratoconus have been established in pediatric patients aged 13 years and older.
GoodRx
Available Forms
Mechanism of Action
Pregnancy & Lactation
Pediatric Use