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    Crosslinking showing potential for refractive correction

    Ease and safety of the non-invasive procedure hold appeal for patients and providers

    Reviewed by Lim Wee Kiak, MD, and Rajesh Rajpal, MD

    Photorefractive intrastromal cross-linking (PiXL) performed with topically applied riboflavin solution and ultraviolet A (UVA) irradiation is a promising technique for non-invasive refractive correction, according to investigators.

    Related: More advances, improvements in emmetropia

    The procedure is not approved in the United States nor is it in clinical trials here, and it is performed with riboflavin products and a crosslinking system that are not for sale in the United States.

    Results from analyses of small series of eyes show that PiXL reduced myopia by about 0.75 D, and in experience that is even more limited, it corrected up to +1.0 D of hyperopia.

    The procedure was not associated with any safety issues, and the refractive effect has been stable during follow-up periods ranging from 9 months to 1 year after myopic corrections, said Matthias Elling, MD, and Lim Wee Kiak, MD.

    Rajesh Rajpal, MD, a cornea specialist in private practice and chief medical officer, Avedro, explained, “PiXL has exciting potential as a refractive procedure because it could appeal to a large group of individuals who would be interested in reducing their spectacle dependence but who consider excimer laser vision correction or a small incision lenticule extraction procedure too invasive and too risky.

    Clinical experience

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