Abstract

P 023

Results of corneal cross-linking with riboflavin and ultraviolet – a light in keratoconus

Kugu Ipek Cubukcu, Riad Khaireddin, Gisbert Richard, Stephan Linke, Toam Katz

Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg

Objective
We report the effect of Riboflavin and Ultraviolet A induced collagen Crosslinking (CXL) in progressive keratoconus 6 months and 1 year after treatment in patients with progressive keratoconus
Methods
10 eyes of 9 patients with topographically or clinically (change of refraction) progressive keratoconus and minimal corneal thickness (MCT) above 400 microns were included into this study. Pre-operatively and post-operatively after six and twelve months, we recorded uncorrected and best corrected visual acuity (UCVA, BCVA), corneal anterior und posterior topography, CCT and MCT from optical corneal thickness maps (Pentacam HR, Zeiss).
CXL was performed after explanation of the procedure and obtaining an informed consent. After local anesthesia with oxybuprocain, corneal epithelium was removed after 30 seconds incubation with alcohol (20%) in 8 mm diameter well. Riboflavin solution 0,1% (every 2 minutes for 30 minutes, ie 16x) was administered to the eye and thereafter activated by illumination with ultraviolet (UV-A) 365 nm wavelength at 9 mm diameter using UV LED lamp (UV-X, Peschke) 3 mw/sqcm for 30 minutes. Therapeutic contact lens was used for 5-7 days until the epithelium was completly closed. Topical antibiotic (Ofloxacin, Mann Pharma ) and steroid eye drops (Prednisolon 1%, Allergan Gmbh) were used for 1-2 weeks.
Results
Efficacy: In 6 eyes BCVA improved and in 2 eyes did not change in the follow up period. The steepest keratometric values increased in 2, were stable in 1 and decreased in 7 of 10 eyes. The average 3 mm central keratometry and keratometric astigmatism increased in 3 eyes, unchanged in 1 eyes and decreased in 6 eyes. Corneal posterior topography values were stable in all of the eyes.
Safety: None of the treated eyes suffered of severe complications such as infectious keratitis, clinical endothelial decompansation, or clinical epithel stem cell deficency. 6 eyes developed stromal haze that improved with topical steroid therapy.
Conclusions
After follow-up of 12 months, CXL seems to be a safe and effective long-term therapeutical option for progressive keratoconus. Still, further studies with longer follow-up periods are necessary.

Copyright: 2009 Porstmann Kongresse GmbH. All rights reserved. Impressum, Disclaimer.