EyeWorld Asia-Pacific December 2017 Issue

col than could be obtained with the classical epi-off technique, as approved. “Because there are complications related to epithe- lium removal, which can include corneal scarring, infectious kerati- tis, and non-infectious ulceration, epi-on is much safer. In addition, patients experience a return to preoperative visual acuity in 2 to 3 days instead of as long as 2 to 3 months. Patients report good comfort in 1 day rather than 1 week. Additionally, there is no epithelial defect postoperatively, except rarely on postoperative day 1. So surgeons do not need to see patients during week 1. Contact lenses and pain medication are not required past day 1. We can also treat comfortably bilaterally instead of unilaterally,” Dr. Stult- ing said. According to Dr. Stulting, an- other benefit to this technique is reduced time. “The loading time with riboflavin varies depending on the individual. There are some predictive factors that determine riboflavin loading time, which we are looking at now for publica- tion. We are able to saturate the cornea in 10 minutes, frequently, rather than 30, as is done with the classic technology. From a pa- tient flow standpoint, we can get a patient in and load the cornea in 10 minutes, expose him or her to ultraviolet light for 30 minutes, and be finished with two eyes in- side of 45 minutes, with discom- fort for 1 day and return to good visual acuity in 2 to 3 days. With the classic technique, treating one eye takes at least an hour, and we can only treat one eye at a time,” he said. EWAP References 1. O’Brart DPS. Corneal collagen crosslink- ing for corneal ectasias: a review. Eur J Ophthalmol. 2017;27:253–269. 2. Shalchi Z, et al. Safety and efficacy of epithelium removal and transepithelial cor- neal collagen crosslinking for keratoconus. Eye (Lond). 2015;29:15–29. Corneal collagen – from page 39 3. Elling M, et al. Photorefractive intrastro- mal corneal crosslinking for the treatment of myopic refractive errors: Six-month interim findings. J Cataract Refract Surg. 2017;43:789–795. Editors’ note: Dr. Stulting has finan- cial interests with CXL Ophthalmics (Encinitas, California). Dr. Elling has no financial interests related to his comments. Contact information Elling: Mat thias.elling@kk-bochum.de Stulting: dstulting@woolfsoneye.com December 2017 40 EWAP SECONDARY FEATURE