Medication Summary
The goals of pharmacotherapy are to reduce morbidity and prevent complications.
Antibiotics
Class Summary
Antimicrobial therapy must be comprehensive and cover all likely pathogens in the context of this clinical setting.
Moxifloxacin ophthalmic (Moxeza, Vigamox)
Moxifloxacin is indicated for treating bacterial conjunctivitis and surgical prophylaxis. It inhibits topoisomerase II (DNA gyrase) and IV enzymes. DNA gyrase is essential in bacterial DNA replication, transcription, and repair. Topoisomerase IV plays a key role in chromosomal DNA portioning during bacterial cell division.
Corticosteroids
Class Summary
Corticosteroids are used for pseudomembranes and decreased vision and/or glare due to subepithelial infiltrates. They have anti-inflammatory properties and cause profound and varied metabolic effects. In addition, these agents modify the body's immune response to diverse stimuli.
Fluorometholone (Flarex, FML, FML Forte, Flarex)
This agent is used to treat ocular inflammation. Suppresses the migration of polymorphonuclear leukocytes and reverses capillary permeability.
Nonsteroidal Anti-inflammatory Drugs
Class Summary
The inhibition of prostaglandin synthesis results in vasoconstriction, a decrease in vascular permeability, leukocytosis, and a decrease on intraocular pressure (IOP). However, these agents have no significant effect on IOP.
Ketorolac ophthalmic (Acular, Acular LS, Acuvail)
Ketorolac ophthalmic inhibits prostaglandin synthesis by decreasing the activity of the enzyme cyclooxygenase. This results in decreased formation of prostaglandin precursors, which, in turn, results in reduced inflammation.
Ophthalmic lubricants
Class Summary
These agents function as tissue lubricants and modulate the interaction between adjacent tissues.
Sodium hyaluronate (Amvisc, Amvisc Plus, Provisc)
Sodium hyaluronate (hyaluronic acid or hyaluronan) is a high molecular mass, biological polysaccharide present in the extracellular matrix of connective tissues and aqueous humor and the vitreous. Also coats the corneal endothelium. It forms a viscoelastic solution in water, which makes it suitable for aqueous and vitreous humor in ophthalmic surgery.
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Corneal cross-linking treatment aims to prevent the progression of keratoconus. Courtesy of Optimed (www.optimed.co.uk).
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Once the eye is numbed with drops, further drops of riboflavin are added to the eye. Riboflavin is instilled until the cornea is saturated. Courtesy of Optimed (www.optimed.co.uk).
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A small dose of UV-A light is used to activate the riboflavin. Courtesy of Optimed (www.optimed.co.uk).
Tables
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- Overview
- Periprocedural Care
- Technique
- Approach Considerations
- Standard cross-linking (CXL)
- Transepithelial cross-linking (TCXL)
- Pocket cross-linking (PCXL)
- Contact lens-assisted collagen cross-linking (CACXL)
- Accelerated cross-linking
- Combined with other refractive eye procedures
- Photorefractive Intrastromal corneal cross-linking (PiXL)
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- Medication
- Laboratory Medicine
- Media Gallery
- References
