Cross-linking therapy a promising treatment for keratectasia

SAO PAULO, Brazil — A therapy that uses ultraviolet light and riboflavin to create cross-linking of corneal collagen may be a promising treatment for keratectasia, a preliminary study has shown.

At the World Ophthalmology Congress, Maria Regina Chalita, MD, reported results from a prospective analysis of the treatment in seven patients who had developed corneal ectasia following LASIK surgery. Prior to the treatment, each patient had progression of ectasia documented by at least two corneal topography maps, she said.

Dr. Chalita said the procedure begins with proparacaine topical anesthesia, followed by mechanical epithelial debridement, and then instillation of a riboflavin solution 5 minutes before UV light irradiation using UV-emitting goggles. Patients then wear a bandage contact lens for 4 days after the treatment.

At the 3-month follow-up point, uncorrected visual acuity had improved in the seven patients and best corrected visual acuity remained the same, Dr. Chalita said.

“Most patients reported better [visual] quality than before surgery,” she said.

“We expected to see a lot of change in corneal topography, but we didn’t,” she continued. “There were no reported adverse affects and no patients lost lines [of visual acuity]. No regression was observed at the 3-month follow up.”

Dr. Chalita concluded that corneal cross-linking with riboflavin and UV light seems to be a safe procedure, but longer-term follow up with a larger patient cohort is needed.