1Wollensak G., 1Spoerl E., 2Seiler T.

1Universitäts-Augenklinik, Fetscherstr. 74, D-01307 Dresden; 2Universitäts- Augenklinik, Frauenklinikstr. 24, CH-8091 Zürich

We were able to show a significant increase in corneal stiffness of rabbitand pig eyes after combined riboflavin/UVA-induced collagen crosslinking. In this study we tried to treat keratoconus patients with this method to stop the progression of corneal thinning in keratoconus.
Methods and Patients: We treated 16 eyes in 14 patients with mild and moderate keratoconus. After removal of the epithelium, riboflavin solution was applied on the cornea, which was irradiated with UVA (370 nm, 3 mW/cm²) for 30 min. Postoperativ follow-up controls were conducted every three months including visual acuity testing, corneal topography and measurements of endothelial cell density. Follow-up time was between one and two years.
Results: In all patients corneal transparency, the degree of keratectasia registered by corneal topography and the density of endothelial cells remained unchanged within the follow-up time. No side-effects were observed.
Conclusions: Our results show that collagen crosslinking might be a useful conservative treatment modality to stop the progression of keratoconus. By this means the need for keratoplasty might be significantly be reduced. Given the minimal costs of the treatment it might also be well suited for developing countries. Further studies are envisaged to find the optimal dosage for the individual degree of keratoconus, to exclude long term side effects and to check the long term durability of the mechanical stiffness effect.

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