Epioxa Epi-On Cross-linking Treatment

 

Epioxa is the first FDA-approved, non-invasive, epithelium-on (epi-on) corneal cross-linking treatment used to slow or halt the progression of keratoconus. Developed by Glaukos Corporation, it strengthens the cornea without removing its protective outer layer. [1, 2, 3]

You can read full product details on the official  Epioxa Website  [1]

How It Works

Unlike traditional "epi-off" cross-linking—which requires scraping away the corneal epithelium—Epioxa leaves the surface intact: [1, 2, 3]

Sequential Riboflavin Drops: The procedure uses Epioxa HD (riboflavin 5′-phosphate ophthalmic solution 0.239%) and Epioxa (riboflavin 5′-phosphate ophthalmic solution 0.177%) applied directly to the eye. [1, 2]
Oxygen Supplementation: Patients wear specialized Boost Goggles connected to the O2n System to deliver supplemental oxygen around the cornea. Supplemental oxygen is critical because the cross-linking reaction consumes oxygen, and an intact epithelium normally restricts airflow. [1, 2, 3]
Pulsed UV-A Activation: Calibrated UV light activates the riboflavin and oxygen mixture to create new collagen cross-links, stiffening and stabilizing the tissue. [1, 2]

Key Details & Eligibility

Patient Profile & Timing: Approved for individuals aged 13 and older, taking 60 to 90 minutes per eye.
Recovery & Results: Retaining the epithelium allows for faster healing within days, while trials demonstrate sustained corneal flattening and visual improvements over 3 years. [1, 2, 3, 4, 5, 6]

Safety Profile

Contraindications: Avoid treatment if pregnant, hypersensitive to ingredients, or possessing a history of herpetic keratitis or specific cataract surgery conditions. [1, 2]
Side Effects: Commonly includes eye redness, corneal haze, photophobia, surface cell disruption, pain, irritation, tearing, swelling, dry eye, and inflammation. [1, 2]