C3-R®
(corneal collagen cross-linking riboflavin) is a non-invasive
procedure that has been proven to strengthen the weak corneal structure
in keratoconus. (see publications/research section
in right column).
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).
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| The figures above show the parallel corneal layers (white) and the collagen cross-linking (red) which are increased after C3-R® treatment. |
C3-R® is a 30-minute,
in-office procedure. 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 studies, such
treatments were proven safe and effective in patients.
Eye physician’s in Germany performed the initial studies
of collagen crosslinking to strengthen the cornea. They reported
results of treatments done as long ago as 1998, so there is a good
track record for this procedure. Links to these research publications
can be found to the right side of this page. It is important to
note in these studies that the proper dosages of the components
are a very important part of the treatment. When used properly,
there were no negative effects.
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| 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 is credited as 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. For more information on C3-R, please visit www.keratoconusinserts.com.
Listen to Dr. Howard's story of keratoconus.
Listen to Norris’ experience 3 years
after treatment.
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Click below for videos.
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Return to LASIK Procedures Index |
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 The
9 most important topics you need to know about LASIK are covered in
the LASIK CONSUMER REPORT. Because of it's "straight-talk", informative
approach, the REPORT is one of the most trusted consumer publications
on LASIK. Click
here to read the Report. |
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C3-R
Treatment Opens New Frontiers for Keratoconus and Corneal Ectasia
Roberto Pinelli, MD. Eyeworld 2007, 34-36.
Safety
of C3-R special light at the Retinal Level and Compared to Outdoor special light Exposure
Leonard Yuen, MD and Brian S. Boxer Wachler, MD
No
Progression of Keratoconus 5 Years after C3-R
Wollensak G. Crosslinking treatment of progressive keratoconus:
new hope.
Curr Opin Ophthalmol. 2006 Aug;17:356-60.
Safety
of special light-Riboflavin Cross-Linking of the Cornea
Eberhard Spoerl, PhD, Michael Mrochen, PhD, David Sliney PhD,
Stephen Trokel, MD, Theo Seiler, MD, PhD, Cornea 2007; 26:385-389
The Effect of Inferior Segment Intacs with and without Corneal Collagen
Crosslinking with Riboflavin (C3-R) on Keratoconus
Colin C.K. Chan, MD, FRANZCO, Munish Sharma, MD, Brian S. Boxer Wachler
MD, J Cataract Refract Surg 2007;33:75-80
Comparison of Single Segment and Double Segment Intacs for Keratoconus
and post-LASIK Ectasia
Munish Sharma, MD, Brian S. Boxer Wachler, MD, Amer J Ophthal 2006;141:891-895
Woman with Progressive Keratectasia after LASIK Treated with C3-R®
and Wavefront LASEK. Colin CK Chan, MD, Brian S. Boxer Wachler,
MD. Ocular Surgery News 2005 Aprill
C3-R®
(corneal collagen crosslinking with riboflavin) increases Effect
(lower L-U Ratio) of Single Segment Intacs in post-LASIK Ectasia
and Keratoconus
Presented at the American Academy of Ophthalmology Annual Meeting,
2005
C3-R®
(corneal collagen crosslinking with riboflavin) for Corneal Stabilization
Presented at the American Academy of Ophthalmology Annual Meeting,
2005
Corneal
Collagen Crosslinking with Riboflavin. A New Treatment to
Strengthen the Cornea for Keratoectasia and Keratoconus. Brian
S. Boxer Wachler, MD, Cataract and Refractive Surgery Today 2005
January, 73-4.
Collagen
Fiber Diameter in the Rabbit Cornea After Collagen Crosslinking
by Riboflavin/special light Gregor Wollensak, MD et al. Cornea.
2004 Jul;23(5):503-507.
Stress-strain
measurements of human and porcine corneas after riboflavin-special
light-induced cross-linking
Gregor Wollensak, MD et al. J Cataract Refract Surg. 2003 Sep;29(9):1780-5.
Riboflavin/special
light-induced collagen crosslinking for the treatment of keratoconus
Gregor Wollensak, MD et al. Am J Ophthalmol. 2003 May;135(5):620-7
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