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Cross-linking in thin corneas may decrease endothelial cell density

Am J Ophthalmol. 2012;153(1):24-28.

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Corneal collagen cross-linking with riboflavin and ultraviolet A irradiation in thin corneas seems to lead to a decrease in endothelial cell density postoperatively, according to a study.

The prospective case series included 14 eyes of 12 participants, 10 with keratoconus and two with post-LASIK ectasia, with minimum corneal thickness less than 400 μm after epithelial removal and before riboflavin instillation.

All patients underwent riboflavin-UVA-induced corneal collagen cross-linking. The researchers evaluated uncorrected and corrected distance visual acuity, manifest refraction, and topography, and they took images of the endothelium.

Endothelial cell density decreased significantly from 2,733 ± 180 cells/mm² to 2,441 ± 400 cells/mm² (P < .01) at 12 months. The decrease was not related to other intraoperative or postoperative complications.

At 12 months, uncorrected distance visual acuity improved from 0.25 ± .015 to 0.27 ± 0.17, and corrected distance visual acuity improved from 0.40 ± 0.20 to 0.49 ± 0.20.