Cross-Linking Vet iCLX

The treatment known as Cross-Linking Vet CLX is an innovative method for treating corneal collagen. It involves using covalent bonds created through exposure to UVA light at 365 nm after applying a riboflavin solution. This process increases the number of bindings and results in a 300% increase in the biomechanical stiffness of the cornea, making it more resistant to enzymatic digestion. Additionally, this treatment destroys bacterial and fungal germs, contributing to rapid clinical improvement. Properly conducted CXL can effectively address ongoing keratomalacia associated with infectious keratitis in dogs, cats, and horses and bubble keratopathy in dogs.

In practice:

During the procedure, the patient is anesthetised and positioned on their side or back, with the treated eye facing upward.

Riboflavin (Vitamin B2) is typically applied through eye drops containing a 0.1% solution, which is hypotonic and increases corneal thickness through osmosis. The drops are administered for 20 to 30 minutes every minute until the stroma is fully saturated, as confirmed by a biomicroscope with a cobalt lamp. However, an Iontophoresis (iCLX) method can limit impregnation time to just 5 minutes by applying a low direct current that promotes the migration of ionised vitamin through IontophorVet® devices. After impregnation, the cornea is exposed to UVA radiation (370 nm) for several minutes from a distance of 1 cm, delivering 5.4 J/cm2 of energy (3 minutes at 30 mW/cm2 or nine minutes at 10 mW/cm2). Clinical effects can be seen within 4-6 days, and corneal healing is expected to occur within 15-20 days.

Cross Linking, or CLX or ICLX, is an excellent option for treating infectious keratitis without performing a tectonic surgery, such as a pedunculated conjunctival graft or biomaterial graft. However, surgery may still be necessary if the remaining cornea is less than 400µm thick or if keratomalacia persists after CLX.