Article Text

other Versions

PDF
A randomised, prospective study to investigate the efficacy of riboflavin/ultraviolet A (370 nm) corneal collagen cross-linkage to halt the progression of keratoconus
  1. David P S O'Brart1,
  2. Elsie Chan1,
  3. Konstantinos Samaras1,
  4. Parul Patel1,
  5. Shaheen P Shah2
  1. 1Department of Ophthalmology, St Thomas' Hospital, London, UK
  2. 2International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to Mr David P S O'Brart, Department of Ophthalmology, St Thomas' Hospital, London SE1 7EH, UK; davidobrart{at}aol.com

Abstract

Aims 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/cm2). 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.

  • Keratoconus
  • cross-linkage
  • riboflavin
  • ultraviolet light
  • cornea
  • dystrophy
  • treatment surgery
  • clinical trial

Statistics from Altmetric.com

Footnotes

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Guy's and St Thomas' Ethic Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • At a glance
    Harminder S Dua Arun D Singh