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Corneal endothelium following trans-epithelial collagen corneal cross-linking using a new riboflavin composition

Poster Details

First Author: R.Barbara ISRAEL

Co Author(s):    H. Garzozi   Y. Pickel   A. Barbara        

Abstract Details


A prospective study to determine the effect of transepithelial riboflavin/UVA cross-linking (CXL) on corneal endothelium. The new Riboflavin contains Benzalkonium Chloride (BAC) and > 0.25 riboflavin in an isotonic solution.


The National Center for the treatment of Keratoconus , a Private Medical center in Haifa Israel and Hadassah Optimal, the Refractive surgery unit of Hadassah Hospital in Haifa, Israel.


: 10 eyes of 10 Patients with documented progression of keratoconus were scheduled for CXL. The CXL was performed without removal of the epithelium, the new TE ribovalvin produced by Peshcke (Germany) was instilled every two minutes for 60- 90 minute and until the appearance of a yellow flare in the anterior chamber. Ultracound pachymetry was done at this stage then a speculum was inserted and the cornea was irradiated by UVA light 365-370 A, 18 milliwatt, for 5 minutes, 5cm (CL-365-18, Peschke, Germany) from the eye. During the treatment BSS was instilled every two minutes, Ofloxacine 0.3% was prescribed for 2-3 days, the patients were examined on the third day and one month after the treatment. Endothelial cell count was performed before treatment using the Tomey specular microscope EM 300), 3 days and one month post treatment in addition to corneal imaging.


: No intra-operative or post-operative complications were noted, the corneas remained clear. The results and statistical analysis of the endothelial cell count will be reported at the presentation.


Although the epithelium was not removed, a yellow flare was observed after a relatively long time and frequent installation of the TE riboflavin, the corneal thickness increased after the installation of the riboflavin and the endothelial cell count and shape seens not to be affected by the treatment. Further studies are needed to confirm the safety and the long term effect of this new treatment protocol. FINANCIAL DISCLOSURE?: No

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