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Three years transepithelial corneal collagen cross-linking by iontophoresis for progressive keratoconus: results

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Session Details

Session Title: Cross-Linking

Session Date/Time: Tuesday 10/10/2017 | 14:00-16:30

Paper Time: 14:44

Venue: Room 4.6

First Author: : L.Lapenna ITALY

Co Author(s): :    E. Albe   A. Acquaviva                 

Abstract Details


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


”Di Venere” Hospital, Dept. of Ophthalmology, Bari, Italy, Humanitas Hospital, Dept. of Ophthalmology, Rozzano(Mi), Italy


I-CXL of riboflavin was performed in a series of 54 eyes of 38 patients with progressive keratoconus. Hypotonic riboflavin solution was administered by iontophoresis for 5 minutes, after which accelerated surface UVA irradiation (10 mW/cm) was performed at a 5-cm distance for 9 minutes. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refractive astigmatism, central corneal thickness, various corneal topography, anterior segment optical coherence tomography and endothelial cell count were evaluated at baseline and at 1, 3, 6, 12, 24 and 36 months. The paired Student t test was used to compare data during the follow-up.


Mean UCVA and BSCVA at three years improved significantly of 55,6% and 49,3%, respectively. Mean spherical equivalent and refractive astigmatism showed a significant decrease of 1 diopter (D) at 3 years in 49 patients (91%). No significant change of central corneal thickness was observed. Only five of the patients ( 9%) showed a progression of keratoconus for up to 36 months. Endothelial cell counts did not change significantly 3251.6±25.7 cells/mm2.


I-CXL of riboflavin seems to be a safe and effective procedure in stabilizing the progression of keratoconus in pediatric and adolescent patients changing its natural course.

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