Transepithelial (Epi-On) Systems and Iontophoresis Adjuncts
A significant technological hurdle has been the corneal epithelium, which naturally acts as a barrier to riboflavin. While traditional "Epi-Off" procedures remove this layer, 2026 has seen a surge in "Epi-On"
(transepithelial) devices that preserve the protective outer surface of the eye.
To overcome the epithelial barrier without surgery, devices now incorporate Iontophoresis. This technology uses a very low-level electrical current to "drive" negatively charged riboflavin molecules through the intact epithelium and deep into the stroma. This approach drastically reduces post-operative pain and the risk of infection, allowing patients to return to their normal activities within twenty-four hours rather than the traditional five-day recovery period.