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Year : 2013  |  Volume : 106  |  Issue : 3  |  Page : 210-216

Anatomical and functional changes in the cornea and retina after ultraviolet-A riboflavin cross-linking in patients with keratoconus

Department of Ophthalmology, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Correspondence Address:
Kamal Enam
Department of Ophthalmology, Faculty of Medicine, Mansoura University, Mansoura
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2090-0686.127407

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Purpose The aim of this study was to evaluate the efficacy of corneal collagen cross-linking in stabilization of the keratoconus and the safety of the procedure in the cornea and retina. Design This study is a prospective interventional case series study. Patients and methods The study included 19 eyes of 19 patients with grade II-III keratoconus. All of them were treated with riboflavin ultraviolet-A collagen cross-linking. The patients were followed up monthly for 6 months. Examination of each patient included evaluation of the uncorrected visual acuity, best-corrected visual acuity, and spherical equivalent; endothelial cell counting; anterior segment optical coherence tomography using a corneal Scheimpflug camera; posterior segment assessment by fluorescein angiography; posterior segment optical coherence tomography; and multifocal electroretinography. Results Uncorrected visual acuity and best-corrected visual acuity showed statistically significant improvement. The mean improvement in spherical equivalent was 1.5 (΁1.0) D. The K-value at the apex significantly decreased (the mean decrease was 1.40 D). There was a significant decrease in the corneal pachymetry at the thinnest location at the first month postoperatively; however, at 3 months postoperatively, the corneal pachymetry increased gradually, reaching stability at the end of the follow-up period. There was a significant increase in the mean intraocular pressure of the treated eyes. Of the treated eyes, 13 showed a demarcation line at a depth of 300 ΁ 10.5 mm. The preoperative mean endothelial cell count showed a statistically significant decrease. Retinal fluorescein angiography, optical coherence tomography, and multifocal electroretinography at the foveal ring showed no abnormalities in the riboflavin-treated eyes. Conclusion Corneal collagen cross-linking is an effective procedure in stopping the progress of keratoconus and is safe for both anterior and posterior segments.

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