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Factors impacting the outcomes of photorefractive intrastromal cross-linking (PIXL)

Poster Details

First Author: R.Rajpal USA

Co Author(s):    G. Lytle   A. Nicklin   D. Usher   D. Adler           

Abstract Details


To analyze the impact of various treatment parameters on the efficacy of PIXL, a novel application of spatially targeted accelerated corneal cross-linking for minimally invasive refractive correction.


Avedro Inc., Waltham, USA


Photorefractive intrastromal corneal cross-linking has been recently introduced as a refractive procedure for the treatment of low myopia through the application of riboflavin and spatially targeted UVA. Clinical investigators have applied this procedure utilizing a variety of treatment protocols. A review of clinical studies of the PiXL procedure has been conducted to identify parameters contributing to treatment success.


A variety of treatment parameters impacting magnitude and precision of refractive correction were evaluated. A statistically significant increase in magnitude of myopia correction (change in manifest refractive sphere) was observed when epithelium-on corneal cross-linking was conducted in an oxygenated environment (>90% oxygen), relative to epithelium-on corneal cross-linking conducted in room air (20% oxygen). Factors contributing to the repeatability of the treatment effect included the UVA beam pattern.


A reduction of myopic refractive error can be achieved with epithelium-on PiXL. Factors contributing to treatment success include oxygen concentration, riboflavin formulation and UVA beam pattern.

Financial Disclosure:

is employed by a for-profit company with an interest in the subject of the presentation

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