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A randomised, prospective study to investigate the efficacy of riboflavin/ultraviolet A (370 nm) corneal collagen cross-linkage to halt the progression of keratoconus.

AbstractAIMS:
A blind, randomised, prospective, bilateral study to investigate the efficacy of riboflavin/ultraviolet A corneal collagen cross-linkage to halt the progression of keratoconus.
METHODS:
24 patients with early/moderate bilateral keratoconus with recent progression were recruited. One eye was randomly assigned to undergo collagen cross-linkage following epithelial removal with riboflavin 0.1% and ultraviolet A (370 nm at 3 mW/cm(2)). The other remained untreated as a control. The follow-up was 18 months in 22 patients.
RESULTS:
At 18 months, Orbscan II 3 mm, 5 mm keratometry and simulated astigmatism and cone apex power and wave-front measurements (Keraton Scout), including root mean square, coma and pentafoil showed significant reductions from baseline in treated compared with untreated eyes (p=0.04). In treated eyes at 18 months, the best spectacle-corrected acuity improved (p=0.01), and Orbscan II-simulated keratometry (p<0.001), 3 mm keratometry (p=0.008), simulated astigmatism (p=0.007), cone apex power (p=0.002), root mean square, coma, spherical aberration, secondary astigmatism and pentafoil (p=0.05) decreased from baseline. One treated eye experienced transient recurrent corneal erosions; otherwise there were no complications attributable to the treatment.
CONCLUSIONS:
Corneal collagen cross-linkage appears to be an effective and safe modality to halt the progression of keratoconus. Improvements in visual and topographic parameters are seen in some eyes.
AuthorsDavid P S O'Brart, Elsie Chan, Konstantinos Samaras, Parul Patel, Shaheen P Shah
JournalThe British journal of ophthalmology (Br J Ophthalmol) Vol. 95 Issue 11 Pg. 1519-24 (Nov 2011) ISSN: 1468-2079 [Electronic] England
PMID21349938 (Publication Type: Journal Article, Randomized Controlled Trial)
Chemical References
  • Photosensitizing Agents
  • Collagen
  • Riboflavin
Topics
  • Adult
  • Collagen (metabolism)
  • Cornea (metabolism)
  • Corneal Topography (methods)
  • Disease Progression
  • Epidemiologic Methods
  • Female
  • Humans
  • Keratoconus (drug therapy, metabolism)
  • Male
  • Photochemotherapy (adverse effects, methods)
  • Photosensitizing Agents (therapeutic use)
  • Riboflavin (therapeutic use)
  • Treatment Outcome
  • Ultraviolet Rays
  • Young Adult

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