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One year transepithelial corneal collagen cross-linking by iontophoresis for progressive keratoconus in pediatric patients: results

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Session Details

Session Title: Cross-linking I

Session Date/Time: Monday 15/09/2014 | 14:30-16:30

Paper Time: 14:36

Venue: Capital Hall A

First Author: : L.Lapenna ITALY

Co Author(s): :    F. Montrone              

Abstract Details


To report the outcomes of Transepithelial collagen cross-linking by iontophoresis of riboflavin in patients below age 18 with progressive keratoconus (KC).


DiVenere Hospital,Bari


Transepithelial collagen cross-linking by iontophoresis of riboflavin was performed in a series of 11 eyes of 7 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 , central corneal thickness and K-max measurements were evaluated at baseline and at 1, 3, 6 and 12 months


Mean logarithm of the minimum angle of resolution baseline UCVA and BSCVA were 0.2 ± 0.24 and 0.1 ± 0.45, respectively. Mean UCVA and BSCVA at one year improved significantly of 56,6% and 48,5%, respectively. No loss in lines of best spectacle visual acuity has been noticed at 6 months postoperatively. Mean spherical equivalent refraction showed a significant decrease of 1 diopter (D) at 12 months. Mean baseline Maximum keratometry decreased of 0.7 D at one year follow-up. No significant change of central corneal thickness was observed. No pain and adverse side effects were reported. Endothelial cell counts did not change significantly 3164.6±25.7 cells/mm2.


Transepithelial collagen cross-linking by iontophoresis of riboflavin seems to be a safe and effective procedure in changing the natural course of keratoconus in pediatric patients. Futher long-term studies are necessary to complete the evaluation of the efficacy and risk spectrum of this modified cross-linking technique.

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