Corneal collagen crosslinking with riboflavin and ultraviolet A to treat induced keratectasia after laser in situ keratomileusis

TLDR

The study aimed to evaluate whether riboflavin and UVA corneal cross‑linking can halt the progression of LASIK‑induced keratectasia. Ten patients with previously undiagnosed forme fruste keratoconus or pellucid marginal corneal degeneration who developed iatrogenic keratectasia after LASIK underwent unilateral cross‑linking at two centers, with procedures performed in a single eye per patient. Cross‑linking arrested or partially reversed keratectasia over up to 25 months, as evidenced by improved corneal topography and lower maximum keratometric values, indicating increased biomechanical stability.

Abstract

PURPOSE: To determine whether riboflavin and ultraviolet-A (UVA) corneal crosslinking can be used as an alternative therapy to prevent the progression of keratectasia. SETTING: Institute for Refractive and Ophthalmic Surgery, Zurich, Switzerland, and a private clinic, Athens, Greece. METHODS: Corneal crosslinking was performed in 10 patients with formerly undiagnosed forme fruste keratoconus or pellucid marginal corneal degeneration who had laser in situ keratomileusis (LASIK) for myopic astigmatism and subsequently developed iatrogenic keratectasia. Surgery was performed in 1 eye per patient. RESULTS: Crosslinking induced by riboflavin and UVA arrested and/or partially reversed keratectasia over a postoperative follow-up of up to 25 months as demonstrated by preoperative and postoperative corneal topography and a reduction in maximum keratometric readings. CONCLUSION: Riboflavin–UVA corneal crosslinking increased the biomechanical stability of the cornea and may thus be a therapeutic means to arrest and partially reverse the progression of LASIK-induced iatrogenic keratectasia.