Long-term efficacy of retention ring-assisted continuous riboflavin application in pulsed-light accelerated corneal collagen cross-linking in keratoconus

Abstract

Purpose : To investigate long-term efficacy and safety of 10-minute continuous application of 0.1% riboflavin using retention ring in pulsed-light accelerated corneal collagen cross-linking on the progression of keratoconus.

Methods : The medical records of 18 eyes of 16 patients with progressive keratoconus who underwent collagen cross-linking at Seoul National University Hospital between 2016 and 2019 were retrospectively reviewed. The patients who were followed-up for more than 3 years were included. Isotonic 0.1% riboflavin was continuously applied for 10 minutes using retention ring in the accelerated cross-linking protocol. Success rate on halting progression of keratoconus, changes of visual acuity, refractive error, topographic indices, central corneal thickness, and endothelial cell density were measured every 12 months for 3 years, and data were compared with the baseline parameters.

Results : Overall success rate was 94.4%. Best corrected visual acuity (logMAR) was significantly improved from preoperative 0.44 to postoperative 0.22 at 3 years (p = 0.04). Maximum keratometry decreased from 52.5 D to 50.4 D (p = 0.005) and corneal astigmatism decreased from 5.8 D to 4.7 D (p = 0.08). Central corneal thickness and endothelial cell density did not significantly change through 3 years.

Conclusions : It suggests that long-term outcome of retention ring-assisted 10-minute continuous riboflavin application in pulsed-light accelerated cross-linking is effective and safe on seizing the progression of keratoconus, and it seems to be comparable with the outcome of conventional Dresden protocol as previous reported.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.