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Topo-guided refractive cross-linking for keratoconus: 1 year results

Poster Details

First Author: R. Fasciani ITALY

Co Author(s):    C. Radini   A. Agresta   A. Caristia   S. Ambrogio   A. Caporossi        

Abstract Details


Through the study of the shape of keratoconus and modulation of the dose of UVA irradiation, it is possible to develop algorithms for treatment or Computer modeling that are intended to reshape and normalize as possible the shape of the cornea.


Institute of Ophthalmology, Catholic University of Sacro Cuore in Rome. Local ethic committee approved on September 2014.


15 patients (mean age 23 years +/- 2.98SD) with keratoconus in II-III Amsler stage, mean UCVA of 0.38 +/- 3.45SD, mean BSCVA 0.78 +/- 5.34SD, mean refractive cylinder of 4.7D +/- 2.34SD, mean Kmax of 59D +/- 7.89SD and minimum pachymetry over 400 micron, underwent to Corneal Refractive Cross Linking procedure using a KXL II UVA emitting System (30-45 mW /cm2, pulsed accelerated irradiation, dose from 5.4J to 15J) and 0.1% riboflavin solution. The treatment algorithm has been developed through the determination and processing of the center of mass of the cone by studying the maximum keratometries with Scheimplflug camera.


There were no intraoperative and postoperative complications, excepted of moderate stromal haze gradually improved over the months. The mean follow-up of 12 months has put highlights in an average reduction of K max equal to 3.7D and a reduction in the mean refractive cylinder of about 2.5D. Still preliminary and unstable to be considered the results in terms of visual acuity (UCVA average +/- 7.77SD 0:55; BSCVA average 0.89 +/- 4.56SD). No evolution of keratoconus in all treated patients was evident during the follow up.


the topo-guided refractive corneal Cross Linking procedure appears a promising technique for reducing the refractive errors in patients with keratoconus. A long-term follow-up results will be needed to evaluate the efficacy and safety of the technique in the prevention of the evolution of the disease.

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