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 Riboflavin 0.1% for Corneal Collagen cross-linking in the treatment of Keratoconus

Description:

Flavin is a sterile, preservative free ophthalmic solution containing Riboflavin 0.1% and Dextran in salined buffer for external ocular usage.

Indications:

It is used as a photo sensitizing agent in Corneal Collagen cross linking as a treatment for patients with Keratoconus and Corneal Ectasias.

Collagen cross linking with Riboflavin - the Mechanism :

  • Riboflavin (vitamin B2) has 2 important functions; it absorbs UV irradiation and acts as a photosensitizer for the generation of reactive oxygen species (singlet oxygen).
  • In combination with UV-A light, Riboflavin forms radicals that cause the cross linking.
  • When Riboflavin penetrates the stroma sufficiently, it shields the deeper tissues such as the Lens and Retina.
  • UV-A light of 370 nm wavelength (Riboflavin’s absorption maximum) and 3mW/cm2 is generally used.
  • The 370 nm wavelength allows approximately 95% of UV-A light to be absorbed into the Cornea; thus, there is no risk for damage to the Lens and Retina.

Collagen cross linking with Riboflavin - the Technique :

  • As a photosensitizer, 0.1% Riboflavin solution is applied to the Cornea 20 minutes before the irradiation to allow sufficient saturation of the Stroma.
  • Next, an 8.0 mm diameter of central Cornea is irradiated with UV-A light with a wavelength of 370 nm and an irradiance of 3 mW/cm2.
  • During the 30 minutes of irradiation, drops of Riboflavin solution is applied to the cornea every 4 to 5 minutes to sustain the necessary concentration of the Riboflavin and prevent desiccation of the Cornea.
  • The Corneal cross-linking treatment with Riboflavin for Keratoconus increases the amount of Collagen cross-linking in the Cornea in order to strengthen the Cornea. The newly strengthened Cornea protects against the bulging out and becoming steep and irregular, consequence of advanced Keratoconus.

Advantages of Cross Linking Treatment with Flavin :

  • Causes an increase in Corneal stiffness of the anterior 200-250 um.
  • Cross- linking effects are directed to the anterior Cornea because of Flavin’s high UV-A absorption capacity. Thus Corneal Endothelium, Lens and Retina will be protected.
  • Dextran in FLAVIN helps :-
    • Maintains the Osmolarity
    • Avoids corneal soaking and swelling during the treatment
  • Halts the progress and causes some regression.
  • No injection, no stitches & no incisions as in Keratoplasty.
  • Quick & Easy treatment with low costs.

Supply:

  • Flavin is supplied in ready to single use sterile Prefilled Syringe of 1.0 ml with sterile single use Cannula.
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