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Contact lens-assisted collagen cross-linking (CACXL) used for thin corneas

Poster Details

First Author: A.Almeida BRAZIL

Co Author(s):    M. Dias   B. Souza   F. Alves   G. Landim   E. Feijó   A. Bittencourt     

Abstract Details


To evaluate the efficacy and safety of contact lens-assisted collagen cross-Linking (CACXL) in eyes with thin corneas which the conventional cross-linkg could not be done.


Department of Cornea, Ophthalmology Hospital of Anápolis, Anápolis, Goiás, Brazil.


This cross-sectional study analyzed data of 09 eyes who underwent CACXL with diagnosis of progressive ectasia with a minimum corneal thickness less than 400 µm after epithelial abrasion. The iso-somolar riboflavin 0.1% in dextran was applied every 3 minutes for 30 minutes after epithelial abrasion. A soft contact lens (0.09-mm thickness, 14-mm diameter) without an ultraviolet filter soaked in riboflavin for 30 minutes was placed on the corneal surface. The cornea was exposed to ultraviolet-A irradiation with instillation of riboflavin. The minimum follow-up was one year with Pentacam (Oculus Optikgeräte GmbH, Wetzlar, Germany) and specular microscopy (Nidek CEM-530, Japan).


All of patients were females with a mean age of 17.22 years (SD 4.68 years). The study showed that there was keratoconus stabilization at 88.89% of eyes and 11.11% the keratoconus continued to progress. Eight eyes (88.89%) (IC 95: 69-100%) had a normal specular microscopy after CACXL and one eye (11.11%) (IC 95: 0-30%) had a specular microscopy with polymegatism, but without pleomorphism and with preserved cell density.


CACXL showed to be an effective technique and safe in thin corneas. The main limitation of this study was a small sample, as CACXL is not yet a widely performed procedure. Other studies are necessary to corroborate these findings.

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