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Prospective randomized study of riboflavin dosing frequency in corneal cross-linking for progressive keratoconus or ectasia

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Session Details

Session Title: Cross-Linking

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

Paper Time: 15:36

Venue: Room 4.6

First Author: : M.Price USA

Co Author(s): :    F. Price Jr                    

Abstract Details


The application of riboflavin/dextran isotonic solution during corneal crosslinking coats the corneal surface with an ultraviolet (UV) absorbent layer, so the purpose of this study was to determine whether the dosing frequency affects treatment efficacy or safety.


USA private practice referral center


Inclusion criteria were progressive keratoconus or ectasia. One eye per subject was randomized to 2-minute or 5-minute riboflavin dosing with the epithelium-off Dresden protocol. The main outcome was change in Kmax by corneal tomography at 6 months; secondary outcomes were changes in UCVA and CDVA.


A total of 510 subjects were randomized and received the allocated treatment. Crosslinking was associated with modest but significant reduction in Kmax (0.74 ± 2.08, p<0.0001), improvement in CDVA (0.072 ± 0.22, p<0.0001), and improvement in UCVA (0.10 ± 0.43, p<0.0001) at 6 months, with no significant differences between the dosing groups. Safety was assessed in 726 treated eyes (including fellow eyes). Three eyes (0.4%) had delayed epithelial healing and 3 (0.4%) were retreated.


Both dosing frequencies resulted in mean corneal flattening and visual improvement. Visually significant adverse events were infrequent with epithelium-off crosslinking in this large cohort.

Financial Disclosure:

research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented

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