C3R or Corneal Collagen Cross-linking with Riboflavin is the new non-surgical, non-invasive treatment for patients with keratoconus. Keratoconus is a relatively rare disease characterized by bulging and thinning of the cornea which is progressive. In these patients, the normally circular corneal surface becomes conical.
What is C3R?
C3R or CXR stands for Corneal Collagen Cross-linking with Riboflavin, a procedure in which the biomechanical properties of the cornea are modified to halt the progression ofcorneal thinning and bulging in patients of keratoconus. In this procedure, the corneais strengthened bycollagen cross linking with Ultraviolet A (UVA, 365nm) and riboflavin (Vitamin B 2), a photosensitizing agent.
How effective is C3R?
In today’s day and age, C3R is considered the standard of care all over the world for patients with progressive keratoconus and indeed, cornealectasia. Because the procedure changes the intrinsic biomechanical properties of the cornea, even a one-time application of really halts, or atleast slows, theprogression of disease.
What does the procedure consist of?
It is arelatively painless, non-invasive procedure. During C3R, the cornea is exposed to approximately 30 minutes illumination with UV-A light, after one time application of riboflavin, which activates it. The riboflavin, then increases the collagen cross-links within the substance of the cornea (stroma), increasing its strength.
After this, a soft bandage with contact lens is placed in the eye and your doctor will antibiotic dropsfor upto a week, along with anti-inflammatory eye drops. The bandage contact lens is usually removed after a day or two.
What are the indications of C3R?
Most patients with progressive keratoconus are suitable for the treatment with C3R. All patients with a mild to moderate bulging and don't have any scarring on the corneamay be eligible for C3R.
Whether your keratoconus requires C3R or a corneal transplant can only be ascertained by a proper eye evaluation by a cornea specialist. Typically C3R is advised to patients with rapid change in the power of glasses, and those who become intolerant to contact lenses.
C3R is not surgery for removal of glasses like LASIK, instead, it helpsstabilize the refractive power of the eye.
What are the advantages of C3R Treatment?
It is a non-surgical, pain-free procedure
No injections, stitches or generalanesthesia
Usually no additional sittings are required, one time procedure.
Does not requirehospitalization
Delays and often removes the need for corneal transplant. Since C3R halts the bulging of the cornea, it reduces the chances of an eventual corneal transplant later in life.
What are the alternate treatments to C3R?
Specialised contact lens,
Intracorneal Rings,
Corneal Transplants