A non-invasive treatment C3-R (corneal collagen cross-linking riboflavin) treatment has been proven to strengthen the weak corneal structure in keratoconus. This method works by increasing collagen cross-linking, which are the natural "anchors" within the cornea. These anchors are responsible for preventing the cornea from bulging out and becoming steep and irregular (which is the cause of keratoconus).

The figures above show the parallel corneal layers (white) and the collagen cross-linking (red) which are increased after C3-R treatment.

The 30-minute C3-R treatment is performed in our office and is a one-time treatment. During the treatment, custom-made riboflavin eyedrops are applied to the cornea, which is then activated by a special light. This is the process that has been shown in laboratory and clinical studies to increase the amount of collagen cross-linking in the cornea and strengthen the cornea. In published European studies, such treatments were proven safe and effective in patients.

The figure above demonstrates almost 10 diopters of corneal flattening in one patient before (left) after this combined treatment (right).

C3-R treatments can also be combined with Intacs to flatten the keratoconus cone even more than with Intacs alone. In these cases, C3-R treatments stablize keratoconus from getting worse as well as help the Intacs reverse the keratoconus steepening that had already occurred up to the time of the treatment. C3-R is also showing promise in stabilizing patients after radial keratotomy.

Dr. Boxer Wachler was the first doctor in North America to use C3-R treatments for keratoconus as well as being the first doctor in the world to combine this treatment with Intacs.