Trans-epithelial corneal collagen cross-linking with iontophoresis for progressive keratoconus

To evaluate the efficacy of trans-epithelial corneal collagen cross-linking (CXL) with Iontophoresis among patients with progressive keratoconus.

It is a prospective interventional study, which is based on 41 eyes of 23 patients, suffering from progressive keratoconus and treated with trans-epithelial corneal cross-linking, using iontophoresis with ETDA and trometamol-enriched riboflavin 5 phosphates 0.1% hypotonic solution (Ricrolin+, Soot Italia SpA, Italy).

The mean of uncorrected distance visual acuity and best corrected distant visual acuity was improved at 6 months with statistically significant differences from baseline (p < 0.05). There was no statistically significant difference in keratometric values, including K₁, K₂, K_m, topographic astigmatism, and central corneal thickness. Patients, who had completed 1 year (21 eyes of 12 patients) of the treatment, showed similar results.

The data indicated that corneal collagens cross-linking with iontophoresis using Ricroli+ may be an effective method in halting the progression of keratoconus without the side effects of epithelial removal, which may be encountered in the standard epi-off CXL procedure.