Copenhagen 2016 Registration Programme Exhibitor Information Virtual Exhibition Satellite Meetings Glaucoma Day 2016 Hotel Star Alliance

10 - 14 Sept. 2016, Bella Center, Copenhagen, Denmark

This Meeting has been awarded 27 CME credits


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Retrospective analysis of the effects of sterile water during corneal cross-linking for keratoconus

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Session Details

Session Title: Presented Poster Session: Cross-linking

Session Date/Time: Sunday 11/09/2016 | 09:30-11:00

Paper Time: 10:40

Venue: Poster Village: Pod 3

First Author: : I.Gustafsson SWEDEN

Co Author(s): :    A. Cardiakides Myers   A. Ivarsen   J. Hjortdal        

Abstract Details


To retrospectively evaluate the effect of adding sterile water (H2O) during corneal crosslinking


Skåne University Hospital, Malmö/Lund, Sweden


Patients with progressive keratoconus (K-max increment ≥ 1D/12 months) were included. Contact lenses were discontinued 2 weeks prior to treatment. Pentacam HR data were aquired immediately before treatment. CXL was performed with epithelial removal, application of riboflavin with dextran (Ribo D) or riboflavin without dextran (Ribo H) during 30 minutes, then UV-A irradiation with continued riboflavin application during 30 minutes. Sterile water (H2O) (1 drop/sec for at least 1 minute) was intermittently used for corneas with thickness ≤400 microns. Consecutive post-CXL follow-ups with Pentacam HR were undertaken


Sixty-one patients completed follow-up at 1 year of whom 38 recieved H2O. H2O (n=38). Type of riboflavin: Ribo D (n=6) and Ribo H (n=32). Median K-max reduction at 1 year was -0.70 D (p=0.002) fig 1. Mean K-max reduction at 1 year was -0.69 D±1.35 D. Non-H2O (n=23). Type of riboflavin: Ribo D (n=3) and Ribo H (n=20). Median K-Max reduction at 1 year was -1.25 D (p=0.005) fig 2. Mean K-max reduction at 1 year was -1.76 D±2.55 D. When comparing the median K-max reduction at 1 year between H2O and non-H2O no significant difference was found (p=0.14)


Corneal crosslinking is generally regarded as a safe procedure. However, it has been suggested that corneal thickness should not fall short of 400 microns during CXL. Our data suggests that addition of sterile water during CXL do not affect the outcome of K-max at 1 year post-CXL. Hence, sterile water could be valuable in allowing thin corneas with progressive keratoconus to be treated with CXL

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