Drug Detail:Photrexa (Riboflavin ophthalmic [ rye-boe-flay-vin-off-thal-mik ])
Drug Class: Miscellaneous ophthalmic agents
Usual Adult Dose for Corneal Refractive Surgery
- After epithelial debridement: Apply 1 drop of the viscous solution to the affected eye every 2 minutes for 30 minutes, then, using a slit lamp, examine the eye for a yellow flare in the anterior chamber
- If the yellow flare is not present: Apply 1 drop of viscous solution to the affected eye every 2 minutes for an additional 2 to 3 drops and check for a yellow flare; repeat as necessary
- If the yellow flare is present AND the corneal thickness is less than 400 microns on ultrasound pachymetry: Apply 2 drops of the solution into the affected eye every 5 to 10 seconds until corneal thickness is at least 400 microns
- During irradiation: Apply 1 drop of viscous solution into the affected eye every 2 minutes for the duration of irradiation (e.g., 30 minutes)
Comments:
- This drug should be used at an irradiation level of 3 mW/cm2 at a wavelength of 365 nm.
- The KXL System manufacturer product information should be referred to for patient positioning.
Uses:
- Treatment of progressive keratoconus
- Treatment of corneal ectasia after refractive surgery
Usual Pediatric Dose for Corneal Refractive Surgery
14 years and older:
- After epithelial debridement: Apply 1 drop of the viscous solution to the affected eye every 2 minutes for 30 minutes, then, using a slit lamp, examine the eye for a yellow flare in the anterior chamber
- If the yellow flare is not present: Apply 1 drop of viscous solution to the affected eye every 2 minutes for an additional 2 to 3 drops and check for a yellow flare; repeat as necessary
- If the yellow flare is present AND the corneal thickness is less than 400 microns on ultrasound pachymetry: Apply 2 drops of the solution into the affected eye every 5 to 10 seconds until corneal thickness is at least 400 microns
- During irradiation: Apply 1 drop of viscous solution into the affected eye every 2 minutes for the duration of irradiation (e.g., 30 minutes)
Comments:
- This drug should be used at an irradiation level of 3 mW/cm2 at a wavelength of 365 nm.
- The KXL System manufacturer product information should be referred to for patient positioning.
Uses:
- Treatment of progressive keratoconus
- Treatment of corneal ectasia after refractive surgery
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
Data not available
Precautions
Safety and efficacy have not been established in patients younger than 14 years.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- See manufacturer product information.
Storage requirements:
- See manufacturer product information.
General:
- This drug should only be used with the KXL System.
- Studies have not been performed in patients 65 years and older.
Monitoring:
- Resolution of epithelial defects
Patient advice:
- Patients should be instructed to avoid rubbing the affected eye for up to 5 days.
- Patients should contact their healthcare provider immediately if severe pain and/or sudden visual changes occur; patients should also contact their healthcare provider if the bandage contact lens falls out/becomes dislodged.
- Patients should be cautioned that light sensitivity, discomfort, and/or the sensation of a foreign body may occur after the procedure. The use of sunglasses may decrease light sensitivity.