Corneal collagen crosslinking with riboflavin and ultraviolet A to treat induced keratectasia after laser in situ keratomileusis

Hafezi, Farhad; Kanellopoulos, John; Wiltfang, Rainer; Seiler, Theo

doi:10.1016/j.jcrs.2007.07.028

« Previous Next »Journal of Cataract & Refractive Surgery
Volume 33, Issue 12 , Pages 2035-2040, December 2007

Corneal collagen crosslinking with riboflavin and ultraviolet A to treat induced keratectasia after laser in situ keratomileusis

From the Institute for Refractive and Ophthalmic Surgery (Hafezi, Seiler), Zurich, Switzerland; the Department of Ophthalmology (Kanellopoulos), New York University Medical School, New York, New York, USA; and private clinics, Athens, Greece (Kanellopoulos), and Munich, Germany (Wiltfang)

Accepted 18 July 2007.

Purpose

To determine whether riboflavin and ultraviolet-A (UVA) corneal crosslinking can be used as an alternative therapy to prevent the progression of keratectasia.

Setting

Institute for Refractive and Ophthalmic Surgery, Zurich, Switzerland, and a private clinic, Athens, Greece.

Methods

Corneal crosslinking was performed in 10 patients with formerly undiagnosed forme fruste keratoconus or pellucid marginal corneal degeneration who had laser in situ keratomileusis (LASIK) for myopic astigmatism and subsequently developed iatrogenic keratectasia. Surgery was performed in 1 eye per patient.

Results

Crosslinking induced by riboflavin and UVA arrested and/or partially reversed keratectasia over a postoperative follow-up of up to 25 months as demonstrated by preoperative and postoperative corneal topography and a reduction in maximum keratometric readings.

Conclusion

Riboflavin–UVA corneal crosslinking increased the biomechanical stability of the cornea and may thus be a therapeutic means to arrest and partially reverse the progression of LASIK-induced iatrogenic keratectasia.