Abstract

SO.06.04

Results after collagen cross linking with riboflavin and ultraviolet A radiation for keratoconus

Kampik D., Kampik K., Heß M., Geerling G.
University Eye Hospital, Wuerzburg

Objective: Photochemical collagen crosslinking with riboflavin and UV-A radiation is reported to strengthen the cornea in keratoconus. In our study we report the postoperative follow-up after crosslinking regarding progression of keratectasia, visual acuity, safety and side effects.
Methods: 38 patients with progressive keratoconus confirmed by topography and patient history received crosslinking treatment. Following corneal abrasion, riboflavin 0,1% solution was applied over 30 minutes and the cornea exposed to UV-A (365 nm) for further 30 minutes (total surface dose 5,4 J/cm²). Follow-up ranged between 3 and 15 months.
Results: All patients showed initial haze (maximum 2+) and increase of epithelial surface irregularity resulting in a temporary loss of vision, but this resolved within 2 months. Even in patients with atopic dermatitis epithelial healing was not delayed. Maximum K readings decreased from 51.4 to 50.3 dpt. The maximum radius of curvature in the keratoconus apex increased by 4,5 dpt for 4-8 weeks postoperatively followed by a decrease below the preoperative value (preop 51,3 dpt vs. postop 50,3 dpt). Visual acuity improved by 1 line on average. Central pachymetry and endothelial cell count remained unchanged.
Conclusions: Collagen cross linking showed no long term complications. Despite transitory visual loss for 4-6 weeks a return or slight increase of visual acuity can be expected. No case showed a progression of keratoconus during this study. A longer follow-up time and a randomized controlled study are crucial for further assessment of this method to establish whether it is capable of preventing progression of keratoconus.

Copyright: Porstmann Kongresse GmbH. All rights reserved. Impressum, Disclaimer.