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Custom corneal cross-linking guided by corneal tomography using scleral contact lenses to upload riboflavin, alcohol-damaged epithelium in selected steeper zones, and punched soft contact lenses to limit the UV light on identified flatter zones

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Session Details

Session Title: Presented Poster Session: Cross-Linking

Venue: Poster Village: Pod 2

First Author: : N.Cesario Pereira BRAZIL

Co Author(s): :    C. Arce   C. Palmeira   C. da Rosa   A. Forseto              

Abstract Details


To show the initial experience with a new protocol for custom corneal crosslinking guided by the anterior topography of the dual Scheimpflug and Placido corneal analyzer using alcohol to damage selected steeper central zone, scleral contact lenses as a reservoir to upload riboflavin, and punched soft contact lenses with UV filter to limit crosslinking in identified flatter zones


Eye Bank Hospital of Sorocaba, São Paulo, Brazil and Private Eye Clinic, Campinas, Brazil.


Anterior 10-mm-diameter tangential maps from the dual Scheimpflug and Placido analyzer were used to identify the area and location of steeper and flatter zones in corneas with keratoconus and radial keratotomy. Ten minutes 9-mW UV crosslinking was performed in the selected steeper zone after its epithelium was damaged with 20% alcohol for 10 seconds using circular metal markers as container. Riboflavine was uploaded using scleral contact lenses as reservoir. UV light was blockade at identified flatter zones using punched soft contact lens masks. Human eyes discarded for transplantation were used to test the uploading of riboflavine using scleral contact lenses


Flat and steeper zones were easy identified in corneas with keratoconus and RK allowing custom crosslinking with UV light exposed only at the selected steeper zone of corneas which epithelium was also selectively damaged with 20% alcohol for 10 seconds. The time to upload riboflavine seemed to be variable, usually more than an hour, however patient did not blockade the surgical theatre, allowing periodic slit lamp examination while waiting comfortable at a separated room. A soft contact lens with UV filter and a custom central punch was used to mask peripheral flatter zones and limit the effect of crosslinking


This is an-going study which includes uploading of riboflavin using scleral contact lenses as reservoir, corneal crosslinking with UV light in selected steeper zones which have had their epithelium selectively damaged with alcohol, and soft contact lenses with a custom hole to mask areas where crosslinking wanted to be limited

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented

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