Conservative Treatment of Keratoconus by Riboflavin-Uva-Induced Cross-Linking of Corneal Collagen: Visual Outcomes and Menagement of Complication

Abstract

Purpose: : To assess the effectiveness of riboflavin-ultraviolet type A rays induced cross-linking of corneal collagen in reducing progression of keratoconus and in improving visual acuity in patients with progressive keratoconus.

Methods: : starting in April 2007 30 eyes of 30 patients (mean ages 20.52 years) with bilateral keratoconus were treated by combined riboflavin-ultraviolet type A rays (UVA) collagen cross-linking. Radiant energy was 3 mW/cm2 or 5.4 joule/cm2 for a 30-minute exposure at 1 cm from the corneal apex after epithelial removal.

Results: : Comparative preoperative and postoperative results showed increases of 2 snellen lines for UCVA and 1 snellen line for BCVA. A mean K reduction of 1.22 diopters was showed by topographic analysis. Corneal symmetry increased early with a significant reduction in comatic aberrations. We had 2 cases of early corneal haze formation at LAC removal in patients without evidence of corneal abnormalities at the biomicroscopical analysis and in vivo confocal microscopy that resolved after intensive therapy with topical steroids.

Conclusions: : we can state that UVA/riboflavin cross-linking of the cornea halts progression of keratoconus in the majority of the cases but it's no lacking in complications.

Keywords: keratoconus • cornea: stroma and keratocytes • wound healing