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Long term safety & efficacy of corneal collagen cross-linking with hypotonic riboflavin solution in the treatment of progressive keratoconus patients with thin corneas

Poster Details

First Author: T.Celik Buyuktepe TURKEY

Co Author(s):    O. Ucakhan-Gunduz                    

Abstract Details


To compare the long-term visual, refractive, topographic and aberrometric changes after corneal collagen crosslinking (CXL) with or without hipotonic riboflavin solution in the treatment of progressive keratoconus patients.


Department of Ophthalmology, Ankara University School of Medicine, Ankara, Turkey.


Progressive keratoconic thin corneas (preoperative central corneal thickness less than 450 µm) that underwent corneal collagen CXL with or without hypotonic riboflavin solution were analyzed retrospectively. Uncorrected distance visual acuity (UDVA), best spectacle-corrected distance visual acuity (CDVA), manifest refraction, slit lamp biomicroscopy, corneal tomography, corneal aberrometry and endothelial cell counts were evaluated at baseline and yearly at all postoperative follow-up examinations until month-36. The outcomes were analyzed by dividing the patients according to the use of only isotonic riboflavin versus isotonic and hypotonic riboflavin solution.


Twenty-three eyes (19 patients) in the hypotonic and 30 eyes (28 patients) in the isotonic groups completed 3 years follow-up. Compared to baseline, the mean UDVA, CDVA and keratometric readings improved statistically significantly in both groups at postoperative year-3, without any statistically significant between-group differences. Progression was not observed in any patient eye in either group. There was no change in the mean endothelial cell density (p>0.05) or no sight threating complication.


Corneal collagen CXL using hypotonic riboflavin solution seems to be safe and effective in halting progression in the thin corneas with keratoconus. The refractive and topographic outcomes of corneal collagen CXL using hypotonic riboflavin were comparable to conventional CXL in our study.

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