Original ArticlesRiboflavin/ultraviolet-a–induced collagen crosslinking for the treatment of keratoconus
Section snippets
Design
This was a prospective, non-randomized pilot study.
Setting and patients
Starting in 1998, 23 eyes of 22 patients (10 females, 12 males) from the University Eye Clinic of Dresden were included in the study. The clinical diagnosis of keratoconus was based on corneal topography (Figure 3) and clinical signs of keratoconus such as stromal thinning, Fleischer ring, Vogt striae, or apical stromal scar. The preoperative progression of keratoconus was confirmed from medical history in all patients, and it was clearly documented by serial corneal topography12 in 12 eyes
Results
The follow-up time ranged from 3 to 47 months, with a mean follow-up time of 23.2 ± 12.9 months (TABLE 1, TABLE 2). Best-corrected visual acuity improved statistically significantly in 15 patients (65%) by an average of 1.26 lines (95% confidence interval, −0.68 to 2.21; P = .026, paired Student t test), comparing the preoperative values on the day of treatment vs the postoperative values of the last examination. The refractive correction improved significantly by an average of 1.14 diopters
Discussion
This study has shown that collagen-crosslinking appears to be effective in stopping the progression of keratoconus quasi “freezing” the cornea. This effect is corroborated by the following data of the study1: Postoperative regression was observed in 70% of patients with a decrease of the mean keratometer values by 2.01 diopters postoperatively despite documented preoperative progression by 1.42 diopters in 52%.2 The postoperative refractive corrections could also be reduced by an average of
Acknowledgements
The authors thank Prof. Josef Wollensak (Berlin) for continuous support and stimulation in the development of the new method.
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