Application of hypotonic riboflavin in corneal crosslinking in patients with keratoconus

• Main Authors: Ana Sofia Lopes, Diana Silva, Susana Henriques, Peter Pêgo, Cristina Vendrell, Isabel Prieto
• Format: Article
• Language: English
• Published: Press of International Journal of Ophthalmology (IJO PRESS) 2020-02-01
• Series: Guoji Yanke Zazhi
• Subjects: keratoconus; cross-linking; riboflavin; thin cornea
• Online Access: http://ies.ijo.cn/cn_publish/2020/2/202002004.pdf
• ISSN: 1672-5123; 1672-5123

AIM:To compare the results of corneal cross-linking(CXL)with isotonic(IR)and hypotonic riboflavin(HR)in patients with keratoconus.<p>METHODS: Retrospective study of 29 eyes/keratoconus patients submitted to CXL, 15 eyes with application of IR(IR group)and 14 eyes with application of HR(HR group). The parameters analysed included(1-year follow-up): best corrected visual acuity(BCVA), sphere and cylinder, central and finer pachymetry, mean and maximum keratometry(Km and Kmax respectively), complications and progression.<p>RESULTS: An increase on the BCVA scale(LogMAR, logarithm of the minimal angle of resolution)was observed in the two groups: 0.26±0.57(IR)and 0.47±0.72(HR)before treatment, and 0.13±0.79(IR)and 0.29±1.52(HR)at the 1y. Only at 1y, the difference was statistically significant(<i>P</i>=0.018, group IR with higher BCVA). The central pachymetry(μm)decreased at 1mo in both groups, and increased in the following months: 497±28 μm(IR)and 432±14 μm(HR)before treatment, and 480±31 μm(IR)and 424±15 μm(HR)to the 1y. The thinner pachymetry(μm)presented the same evolution: 487±29 μm(IR)and 410±20 μm(HR)before treatment, and 468±33 μm(IR)and 413±13μm(HR)at 1y. Km and Kmax decreased in both groups(<i>P</i>>0.05). 6 eyes from each group presented transitory haze. No eye progressed to the 1y.<p>CONCLUSION:The use of hypotonic riboflavin seems to be a valid alternative for performing the traditional corneal cross-linking technique in eyes with a central corneal thickness of <400 μm.