[Corneal cross-linking with hypo-osmolar riboflavin solution for keratoconus with thin corneas]

Area of Science:

• Ophthalmology
• Corneal Surgery
• Biomaterials Science

Context:

• Keratoconus is a progressive thinning of the cornea.
• Thin corneas (<400 µm) pose a challenge for standard collagen cross-linking (CXL).
• Hypo-osmolar riboflavin solution may enhance CXL efficacy in thin corneas.

Purpose:

• To evaluate the 1-year outcomes of UVA-CXL using a hypo-osmolar riboflavin solution in eyes with thin corneas.
• To assess the safety and efficacy of this modified CXL technique for keratoconus progression.
• To determine if this method prevents stromal scarring.

Summary:

• 32 eyes with thin corneas (<400 µm) underwent hypo-osmolar riboflavin-UVA CXL.
• Corneal thickness increased post-treatment (337±51.9 µm to 451.8±46.7 µm).
• One-year follow-up showed stable keratoconus (K-value unchanged) and visual acuity (VA).
• No stromal scarring was observed post-procedure.

Impact:

• Hypo-osmolar riboflavin-UVA CXL is a viable option for stabilizing thin corneas in keratoconus patients.
• This technique appears to mitigate the risk of stromal scarring associated with CXL.
• Provides a potential treatment to halt keratoconus progression in cases with limited corneal thickness.