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Two years transepithelial corneal collagen cross-linking by Iontophoresis for progressive keratoconus: results

Poster Details

First Author: l.lapenna ITALY

Co Author(s):    L. Lapenna   F. Montrone                 

Abstract Details


To report two years results of Transepithelial collagen cross-linking by iontophoresis (I-CXL) of riboflavin in patients with progressive keratoconus (KC).


Di Venere Hospital Bari, Italy


I-CXL was performed in a series of 42 eyes of 34 patients with progressive keratoconus stage II-III of Amsler classification. Hypotonic riboflavin solution was administered for 5 minutes by iontophoresis, after which accelerated surface UVA irradiation  for 10 mW/cm nm, 3  (3702 ) was performed at a 5-cm distance for 9 minutes at 370 nm, 10 mW/cm2. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refraction , various corneal topography, anterior segment optical coherence tomography and endothelial cell count were evaluated at baseline and at 1, 3, 6,12 and 24 months.


Mean logarithm of the minimum angle of resolution baseline UCVA and BSCVA were 0.2 ± 0.21 and 0.1 ± 0.44, respectively. Mean UCVA and BSCVA at two years improved significantly of 54,8% and 42,8%, respectively. Only three of the patients (7%) showed a progression of keratoconus for up to 24 months. Mean spherical equivalent refraction showed a significant decrease of 1 diopter (D) at 24 months. Mean baseline Maximum keratometry decreased of 0.8 D at two years follow-up. Minimum corneal thickness values were stable for up to 24 months postoperatively. No pain and adverse side effects were reported. Endothelial cell counts did not change significantly.


I-CXL of riboflavin seems to be a safe and effective procedure in stabilizing the progression of this disease combined with significant improvement of BCVA in patients with keratoconus. Results up to 2 year postoperatively indicate the efficacy of I-CXL as a valid alternative for halting the progression of keratoconus while reducing postoperative patient pain, risk of infection, and treatment time in select patients; however, the relative efficacy of this technique compared to standard epithelium-off techniques remains to be evalueted.

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