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Two views of the collagen cross- linking machine

and safety evaluations show no apoptosis of endothelial cells, if the corneal thick- ness is at least 400 microns pre-treat- ment and there has been no change in the clarity of the cornea or the lens. Professor Seiler has, however, reported that the long-term data available in rabbits treated with the riboflavin/UV light cross-linking technique, show that keratoconus eventually begins to progress again. 7

The future for collagen cross-linking is a very exciting one. It may also be used to treat other ectatic disorders – pellu- cid marginal degeneration, post-Lasik keratectasia – and because of its low cost, it may have applications in developing

countries, where corneal grafts are not readily available.

References 1 Spoerl E, Huhle M, Seiler T. Induction of cross-links in corneal tissue. Exp Eye Res, 1998;66:97-103. 2 Wollensak, G, Spoerl E, Wilsch M, Seiler T. Endothelial cell damage after riboflavin- ultraviolet-A-treatment in the rabbit. J Cataract Refract Surg, 2003;29:1786-1790. 3 Wollensak G, Wilsch M, Spoerl E, Seiler T. Collagen fiber diameter in the rabbit cornea after collagen-crosslinking. Cornea, 2004;23:503-507 4 Spoerl E, Wollensak G, Dittert DD, Seiler T. Thermomechanical behaviour

of collagen cross-linked porcine cornea. Ophthalmologica, 2004;218:136-140. 5 Spoerl E, Seiler T. Techniques for stiffening the cornea. J Refract Surg, 1999;15:711- 713 6 Hagele G, Boxer Wachler BS. Corneal collagen crosslinking with riboflavin (C3-R) for corneal stabilization. Presented at the international congress of corneal cross linking (CCL). December 9-10, 2005. Zurich, Switzerland. 7 Wollensak G, Spoerl E, Reber F, Seiler T. Keratocyte cytotoxicity of riboflavin/UVA treatment in vitro. Eye, 2004;18:718-722.

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