Eyeworld

MAR 2012

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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80 EW CORNEA The latest continued from page 79 (Zurich, Switzerland), which is the think tank of the original crosslink- ing procedure, has just introduced a device that goes up to 10 mW, and Peschke Meditrade GmbH (Zurich, Switzerland) introduced a device that goes up to 18 mW, Dr. Kanellopoulos said. Dr. Donnenfeld cautioned that there's not a lot of data comparing these to the traditional crosslinking done with a 3 mW unit. Rethinking crosslinking itself Researchers are also revisiting the process of crosslinking. "We always thought that crosslinking was a photochemical type 2 reaction run by the oxygen singlets produced by the sensitized riboflavin," Dr. Kanellopoulos said. However, experiments done by Avedro recently in cadaver corneas that mimicked the standard tech- nique showed that the oxygen is de- pleted in the cornea within almost a minute through the procedure and is replenished about 20 minutes into the procedure, he said. "That raises a big question mark. What runs the reaction be- tween minute 1 and minute 20? There's speculation that there's an- other type of photochemical reac- tion, which is run not by the oxygen singlets, but riboflavin itself becomes a triplet and it may directly crosslink the cornea," Dr. Kanellopoulos explained. If the actual vehicle of crosslink- ing is riboflavin, it changes the whole protocol of how the drops are applied, how the cornea is exposed, and so on, he said. "There's a lot of work that needs to be done in this direction. I per- sonally am starting to tap into the knowledge of photosensitizing by riboflavin, which is very vast in sterilization of blood products. There are commercially available techniques of inserting riboflavin within plasma, for example, which is high risk for transfusion, and then sensitizing with UV light in order to create sterilization of that packet," Dr. Kanellopoulos said. EW Editors' note: Dr. Donnenfeld has no financial interests related to this article. Dr. Kanellopoulos has financial interests with Avedro. Contact information Donnenfeld: 516-446-3525, eddoph@aol.com Kanellopoulos: ++30-210-74-7277, ajk@laservision.gr March 2012 The next generation Ocular Response Analyzer Reichert pioneered the measurement of corneal biomechanical properties with the development of Corneal Hysteresis and Corneal Compensated IOP (IOPcc). Learn why corneal biomechanics is more relevant now than ever before. EyeWorld factoid ® All-in-one, touchscreen design & enhanced measurement repeatability. Keratoconus is the most common corneal dystrophy in the U.S., affecting one in every 2,000 Americans. It is more prevalent in teenagers and adults in their 20s Source: National Eye Institute, National Institutes of Health Reichert is Corneal Biomechanics. Learn more at www.reichert.com Proudly Made in the USA Follow us: @ReichertTech © 2012 AMETEK, Inc. All rights reserved. 01/12 Reichert and Ocular Response Analyzer are registered trademarks of Reichert, Inc. Reichert Technologies and associated slogan are trademarks of Reichert, Inc. AMETEK is a registered trademark of AMETEK, Inc. Visit us at: ASCRS Chicago, IL April 21 - 24, 2012 Booth 1211

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