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Intraoperative corneal thickness changes during pulsed accelerated corneal cross linking using isotonic riboflavin with HPMC

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Session Details

Session Title: Cornea
Session Date/Time: Sunday 28/02/2016 | 08:30-11:00
Paper Time: 09:36
Venue: MC2 Room
First Author: : N.Elghryany EGYPT
Co Author(s): :    A. Sherif   Y. Salah   L. Samy   A. Osman   M. Grentzelos   G. Kymionis

Abstract Details


To evaluate corneal thickness changes during pulsed accelerated corneal crosslinking (CXL) for keratoconus using a new isotonic riboflavin formula.


eyeCare Center, Maadi, Cairo


In this prospective, interventional, clinical study patients with grade 1-2 keratoconus (Amsler-Krumeich classification) underwent pulsed accelerated (30mW/cm2) CXL after application of an isotonic riboflavin solution (0.1%) with HPMC for 10 minutes. Central corneal thickness (CCT) measurements were taken using ultrasound pachymetry before and after epithelial removal, after riboflavin soaking and immediately after completion of UVA treatment.


Twenty eyes of 11 patients (4 male, 7 female) were enrolled. Mean patient age was 26±3 (range from 18 to 30 years). No intraoperative or postoperative complications were observed in any of the patients. Mean CCT was 507±35 μm (range 559-459 μm) before and 475±40 μm (range 535-420 μm) after epithelial removal (P<0.001). After 10 minutes of riboflavin instillation, there was a statistically significant decrease of CCT by 6.2% from 475±40 μm (range 535-420 μm) to 446±31 μm (range 508-400) (P<0.005). There was no other statistically significant change of CCT during UVA irradiation.


A significant decrease of corneal thickness was demonstrated during the isotonic riboflavin with HPMC application while there was no significant change during the pulsed accelerated UVA irradiation.

Financial Disclosure:


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