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E. C. Lai, A. J. Kanellopoulos; Keratoconus Management: Riboflavin / Ultraviolet A-induced Collagen Cross-linking Followed by Surface Excimer Ablation. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5324.
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To evaluate the clinical safety & efficacy of riboflavin / UVA induced collagen cross-linking pre-treatment for stabilization of keratoconus followed by surface excimer ablation for visual rehabilitation.
36 eyes with keratoconus were included. After central corneal abrasion and pre-treatment with riboflavin drops, eyes were exposed to UVA (370 nm, 3 mW/cm2) at a 2 cm distance for 30 min. All eyes were further treated with topography-guided surface ablation utilizing the Wavelight, Allegretto TCAT platform. Refraction, UCVA, BSCVA, topography (TP), endothelial cell count (ECC), and pachymetry (PC) were evaluated for 35 (11 to 39) months.
In all treated eyes, the progression of keratoconus appeared to stabilize. Visual acuity, both UCVA (20/400 to 20/50) and BSCVA (20/100 to 20/30) improved drastically. There was a reduction in spherical equivalent of 7.4 D. ECC was unchanged. Mean keratometry changed from 55 to 47.5 D. Pachymetry decreased from 420 to 390 microns.
Riboflavin / ultraviolet A-induced collagen cross-linking followed by surface excimer ablation may offer effective visual rehabilitation in keratoconus. Long term results are necessary to evaluate the duration of effectiveness and to exclude long term side effects.
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