Latest Research In Crosslinking

Published in Cornea: July, 2023. Epstein, RJ, Belin, MW, Gravemann, D, Littner, R, Rubinfeld, RS 

Conclusions: This [FDA study reporting on 2,238 subjects] examined the response of …patients with keratoconus to an “epi-on” CXL procedure using a novel technique for riboflavin delivery and…variations of UVA exposure protocol. Robust improvements  were observed in visual acuity sustained over 12 months in a keratoconus population…

including a large subset of young subjects 21 years old or younger…The results support our contention that this represents a safer, noninvasive crosslinking to arrest the progression of keratoconus.

Doyle Stulting, MD, PhD, William B. Trattler, MD, Jonathan M. Woolfson, MD, Roy S. Rubinfeld, MD, MA,   Journal of Cataract and Refract Surgery November 2018.

Conclusion: Epithelium-on CXL using this new protocol halted the progression of keratonus and ectasia after LASIK. It was safer and provided more rapid visual recovery than CXL with epithelial removal, allowing routine bi-lateral simultaneous treatment. 

Roy Rubinfeld, MD, R. Doyle Stulting, MD, Glenwood Gum, PhD, Jonathan Talamo, MD. Journal of Cataract and Refractive Surgery. Feb, 2018 Erratum: J Cataract Refract Surg. April, 2018

What this paper adds: 

• The test transepithelial CXL system achieved corneal stromal concentrations of riboflavin that were 4-fold higher than those achieved with a commercially available transepithelial CXL system and that are theoretically adequate for effective CXL
• A standardized slitlamp grading system can be used to estimate the riboflavin concentration in the corneal stroma.

Rubinfeld, RS, Glenwood, GG, Talamo, JH, Parsons, EC. Clinical Ophthalmology, May, 2021

Conclusion: The addition of NaI [sodium iodide-patented simple salt] to riboflavin solution is associated with increased riboflavin concentration in corneal stroma.

Rubinfeld RS, Caruso C, Ostaloco C. Journal of Cataract and Refractive Surgery April, 2019.

[No other Epi-On CXL system has been shown to adequately stop progression of keratoconus] …recent peer-reviewed publications and supporting basic science research clearly show that optimized transepithelial CXL can stop the progression of corneal ectasia and consequent vision degradation inherent in keratoconus and that because of the adverse events associated with epith

Sinjab, MM, Rubinfeld, RS, Wagner K, Parsons, EC, Cummings AB, Belin, MW. Clinical Ophthalmology, March, 2021.

In summary, the current study describes a new technique that appears effective at improving and stabilizing vision over an intermediate period of follow-up (months to years) in eyes that had lost substantial CDVA [vision with glasses correction] due to corneal ectasia. Significant improvements in VA, the most important metric evaluated for alleviating morbidity and affecting patient satisfaction, were documented.

Rubinfeld RS, Caruso C, Ostacolo C. Cornea, March, 2019 

Conclusions: When standard CXL was the only effective treatment, its drawbacks were relatively less important, with dramatically lower risk-to-benefit ratio compared with penetrating keratoplasty or no treatment. Since its introduction approximately 15 years ago, however, several technological innovations have been proposed and clinically tested to improve corneal CXL. 

Rubinfeld,    Roy S., MA, M.D.; Littner, Roxanne MS; Trattler William B., M.D.; Lindstrom, Richard L., M.D. Journal of Refractive Surgery. 2013;

Mazen M. Sinjab Arthur B. Cummings Editors

R. Doyle Stulting, MD, PhD, William B. Trattler, MD, Jonathan M. Woolfson, MD, Roy S. Rubinfeld, MD, MA

Roy S. Rubinfeld, MD, MA, R. Doyle Stulting, MD, PhD, Glenwood G. Gum, MS, PhD, Jonathan H. Talamo, MD

Roy Rubinfeld, MA, MD,  Jonathan Talamo, MD, Doyle Stulting, MD, PhD

Cosimo Mazzotta, MD, PHD and Roy Rubinfeld, MD, MA - Cataract and Refractive Surgery Today 2017

Roy S. Rubinfeld, MD, Rachel H. Epstein, MD, Parag A. Majmudar, MD, Deborah Kim, OD, Michael Choi, BS, Randy J. Epstein, MD - Journal of Cataract and Refractive Surgery, 2017

Roy Rubinfeld, MD

William B. Trattler, MD - Cataract & Refractive Surgery Today Europe February 2014

Christopher Kent - Review of Ophthalmology September 2015

Michael Korchak, MD; Roxanne Littner, MS; Briana E. McFadden, MHA; MS; Tonoa Person, COT; William Trattler, MD; Roy Rubinfeld, MD

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Healios.com: Ocular Surgery News

Healio.com: Ocular Surgery News

Healio.com: Ocular Surgery News

Richard L. Lindstrom, MD

Ocular Surgery News

Angunawela, R. I., MRCOphth; Arnalich-Montiel, F., PhD, MD; Allan, B. D.S, MD, FRCOphth

Rubinfeld, R. S.

Rubinfeld, R. S.

Alio, Jorge

Erik Letko, MD Parag A. Majmudar, MD S. Lance Forstot, MD Randy J. Epstein, MD Roy S. Rubinfeld, MD

Michelle Dalton

Linda Roach

Sandra G. Boodman

Christopher Kent

Eef van der Worp

W. Trattler, P. Majmudar, R. Rubinfeld. S. Feldman

A. Cummings, S. Daya, G. Kanellopoulos, A. Leccisotti, M. Mrochen, R. Rubinfeld, T. Seiler, A. Stojanivic, W. Trattler

ROY S. RUBINFELD, MD; WILLIAM B. TRATTLER, MD; NEIL F. MARTIN, MD; MARWA A. ADI, MD; AND THE CXL-USA STUDY GROUP

BRIAN S. BOXER WACHLER, MD; ROY S. RUBINFELD, MD; DAVID A. WALLACE, MD; ARUN C. GULANI, MD; AND MITCHELL A. JACKSON, MD