Name of the Procedure:

Riboflavin 5'-Phosphate, Ophthalmic Solution, up to 3 ml (J2787)

Summary

This procedure involves the application of Riboflavin 5'-Phosphate (a form of Vitamin B2) directly to the eye in a solution form. It is typically used in corneal collagen cross-linking (CXL) to treat certain eye conditions.

Purpose

The primary purpose is to strengthen and stabilize the cornea by increasing collagen cross-linking through activation by UV light. It helps in treating and halting the progression of conditions like keratoconus and post-LASIK ectasia.

Indications

• Patients with progressive keratoconus
• Post-LASIK ectasia
• Corneal edema resistant to other treatments
• Conditions causing corneal thinning or weakening

Preparation

• Detailed ophthalmic examination
• Corneal mapping (topography) to assess the curvature and thickness
• Avoid use of contact lenses for a few days prior
• Pre-procedure consultation to discuss risks and benefits

Procedure Description

1. Local anesthesia is applied to the eye.
2. The epithelium (outer layer of the cornea) may be gently removed to enhance riboflavin penetration.
3. Riboflavin 5'-Phosphate solution is applied to the cornea and allowed to soak for 30 minutes.
4. The cornea is then exposed to UV light for another 30 minutes while riboflavin continues to be applied intermittently.
5. The procedure is completed with a bandage contact lens placed on the eye.

Duration

Approximately 60-90 minutes.

Setting

Performed in an outpatient clinic or specialized ophthalmic surgery center.

Personnel

• Ophthalmologist or corneal specialist
• Ophthalmic nurses and technicians

Risks and Complications

• Temporary discomfort and light sensitivity
• Infection
• Corneal haze or scarring
• Failure to halt disease progression (rare)

Benefits

• Stabilizes cornea and prevents further deterioration
• Potential to improve vision in the long term
• Minimally invasive with local anesthesia

Recovery

• Use antibiotic and anti-inflammatory eye drops as prescribed
• Avoid rubbing or touching the eye
• Follow up with the ophthalmologist within a week
• Full recovery typically occurs within a month, with gradual visual improvement over several months

Alternatives

• Rigid gas permeable contact lenses
• Corneal implants (Intacs)
• Corneal transplant in severe cases

Patient Experience

Patients might experience mild discomfort and light sensitivity immediately after the procedure. Pain is typically managed with oral pain relief and eye drops. Blurred vision during the healing process is normal and improves gradually.