Effect of the continuous application of riboflavin in an accelerated pulsed-light collagen cross-linking on the progression of keratoconus

Session Details

Session Title: Cross-Linking Protocols

Session Date/Time: Monday 24/09/2018 | 14:00-16:00

Paper Time: 14:12

Venue: Room A3, Podium 3

First Author: : C.Kim SOUTH KOREA

Co Author(s): :    M. Kim                    

Abstract Details

Purpose:

To investigate the efficacy and safety of the continuous application of 0.1% Riboflavin in an accelerated pulsed-light collagen cross-linking on the progression of keratoconus

Setting:

This study included 21 eyes of 19 patients with progressive keratoconus who received collagen cross-linking at Seoul National University Hospital by a single surgeon (MK Kim). The medical records of 19 patients were retrospectively reviewed.

Methods:

0.1% Riboflavin (Vibex Rapid, Avedro Inc., Waltham, MA, USA) containing hydroxypropyl methylcellulose was continuously applied for 10 minutes using 8.0 mm retention ring after epithelial peeling. The patients received accelerated cross-linking with 30 mW pulsed-ultraviolet light at wavelength 365 nm (Avedro Inc) for 8 minutes [1 second on/1 second off; 30 mW/cm2, cumulative dose of 7.2J/cm2], During the ultraviolet exposure, central trephined ultraviolet-blocking contact lens (trephined diameter; 8.5 mm) was applied to cover the limbal area. Visual acuity, refractive error, topographic index, corneal thickness, and endothelial cell density were evaluated at pre-operation, and postoperative 1, 3, 6, and 12months.

Results:

Best corrected visual acuity in LogMAR improved from preoperative 0.41 to 0.18 in 12 months. Maximum keratometry decreased from 52.2D to 50.2D at 6months (p=0.0062) and 50.3D at 12months (p=0.0004). Minimum keratometry decreased from 46.51D to 46.38D at 12month (p=0.0162). Astigmatism decreased from preoperative 5.6D to 3.9D at 12months (p=0.0008). Spherical equivalents were not significantly different. Thinnest corneal thickness decreased at 3 (p=0.0120) and, 6months (p=0.0054), but recovered in 12 months (p>0.05). Endothelial cell density decreased from 2731/mm2 to 2382/mm2 at 1month (p=0.0218) but gradually recovered in 12 months (2548/mm2, p>0.05 ).

Conclusions:

Continuous application of Riboflavin using retention ring in an accelerated pulsed-light collagen cross-linking seems to be effective and safe on halting the progression of the keratoconus.

Financial Disclosure:

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