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Updated: May 24, 2026
Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
Published on: November 12, 2015
Riboflavin injection into the corneal channel for combined collagen crosslinking and intrastromal corneal ring
Aylin Kılıç1, Gunhal Kamburoglu, Arsen Akıncı
1Dünya Eye Hospital (Kılıç), Istanbul, Turkey. aylinkiliedr@gmail.com
Purpose:
To evaluate the effectiveness of intracorneal riboflavin injection for combined collagen crosslinking (CXL) and intrastromal corneal ring segment (ICRS) implantation.
Setting:
Kudret Eye Hospital, Ankara, Turkey.
Design:
Noncomparative case series.
Methods:
Keratoconic eyes had combined ICRS (Intacs) implantation and transepithelial CXL with 20% alcohol application and riboflavin injection into the corneal channel. Outcome measures were uncorrected (UDVA) and corrected (CDVA) distance visual acuities, sphere, cylinder, and keratotomy (K) readings.
Results:
The study enrolled 131 eyes (105 patients) with a mean follow-up of 7.07 months ± 4.66 (SD). The mean improvement was 0.26 ± 0.16 logMAR in UDVA and 0.24 ± 0.16 logMAR in CDVA (both P<.05). The mean manifest spherical refraction decreased from -3.87 ± 4.55 diopters (D) to -1.25 ± 2.31 D, the mean manifest cylinder improved from -3.89 ± 1.97 D to -2.27 ± 2.18 D, and the mean K reading improved from 50.50 ± 5.26 D to 46.03 ± 4.51 D (all P<.05). There were no intraoperative or postoperative complications.
Conclusions:
Combined ICRS and CXL treatment with intracorneal riboflavin injection was effective in keratoconic eyes. Intracorneal riboflavin injection into the tunnel was safe and may provide more penetration without epithelial removal.
Financial Disclosure:
No author has a financial or proprietary interest in any material or method mentioned.
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