Progressive keratoconus and corneal ectasia following refractive surgery
Epithelium debrided to about 9 mm, then 1 drop of Photrexa Viscous every 2 minutes for 30 minutes, followed by UVA irradiation with the KXL System
The epithelium-off protocol: it hurts and it heals slowly, which is the trade for the strongest evidence base
Contraindications
None.
Available Forms
Ophthalmic solution, single-use foil pouches of Photrexa Viscous (riboflavin 5'-phosphate with dextran 0.146%) and Photrexa (riboflavin 5'-phosphate 0.146%).
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
Ulcerative keratitis can occur; monitor for resolution of the epithelial defect.
Common Side Effects
the most common ocular adverse reactions in any CXL-treated eye were corneal opacity (haze), punctate keratitis, corneal striae, corneal epithelium defect, eye pain, reduced visual acuity, and blurred vision.
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 corneal collagen cross-linking has not been established in pediatric patients below the age of 14 years.
GoodRx
Available Forms
Mechanism of Action
Pregnancy & Lactation
Pediatric Use