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Belquiz A. Nassaralla, Joao J. Nassaralla, Jr.; Corneal Thickness Changes During Corneal Collagen Cross-linking With Ultraviolet-a Irradiation And Hypo-osmolar Riboflavin Solution In Thin Corneas. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1522.
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To evaluate the corneal pachymetric variations during and after corneal collagen cross-linking (CXL) treatment with ultraviolet-A irradiation (UVA) and hypo-osmolar riboflavin solution in thin corneas.
Eighteen eyes of 18 patients, 11 men and 7 women, with progressive keratoconus and thinnest corneal thickness (TCT) less than 400µm. After the epithelium removal, iso-osmolar riboflavin was applied to the cornea every 3 minutes (30min). Hipo-osmolar riboflavin was then applied every 20 seconds until the TCTreached 400µm. UVA irradiation was performed for 30 min. Pachymetry was recorded at the thinnest point of the cornea preoperatively, after epithelial removal, after iso-osmolar riboflavin, after hypo-osmolar riboflavin, after UVA irradiation, and at 1, 6 and 12 months.
Mean patient age was 24 years. Mean preoperative TCT was 380µm. After epithelial removal, mean TCT was 341µm. After iso-osmolar riboflavin instillation it was 330µm. After hypo-osmolar riboflavin it was 418 µm. After UVA irradiation it was 384µm. At 1, 6 and 12 months it was 372µm, 381µm, and 379µm, respectively. After 12 months, all corneas remained clear.
Hypo-osmolar 0.1% riboflavin solution seems to be safe and effective for swelling thin corneas and allowing a CXL for the treatment of progressive keratoconus.
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