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Corneal collagen cross-linking with riboflavin and UV light in combination with other therapeutic methods for treatment of keratoconus

Poster Details

First Author: M.Jankov SERBIA

Co Author(s): V. Jovanovic   L. Nikolic   T. Mrakovic              

Abstract Details


To present and analiyze feasability, efficacy and safety of different treatment combinations for treating keratoconus (KC): corneal collagen crosslinking (CXL) in combination with topography-guided photorefractive keratectomy (tPRK), intracorneal ring segments (ICRS) and phakic IOLs.


LaserFocus - Centre for Eye Microsurgery, Belgrade, Serbia


Forty-eight eyes of 43 patients with KC stage 1 to 2 were submitted to CXL treatment with 0.1% riboflavinom and UV light. A combination of ICRS, tPRK and phakic IOL was carried out in patients depending on their associated refractive error: tPRK with maximal depth of 50 microns was performed after a 50 microns PTK was used for the patients with lower refractive error, ICRS using a femtosecond laser was applied in patients with higher ametropia associated with significant corneal assymetry, while phakic IOL has been implanted in patients with higher ammetropias and a regular cornea.


Six months after CXL only, manifest astigmatism (Cyl) has been reduced from -4.38 +/- 2.03 D to -3.94 +/- 2.30 D, and after additional implanation of ICRS furhter downt to -2.62 +/- 1.93 D; maximal corneal curvature (Kmax) has been reduced from 52.47 +/- 4.01 D tp 51.59 +/- 4.01 D after CXL only, and further to 48.31 +/- 3.65 after ICRS. Inverse order combination showed higher synergic flattening effect. After additional tPRK as the third procedure, Kmax was reduced fromĀ 47.80 +/- 3.97 D to 44.69 +/- 3.19 D.


Combination of CXL with tPRK, ICRS i phakic IOLs can be used with high degree of safety, efficacy and stability in treatment of modreate keratoconus.

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