Riboflavin injection into the corneal channel for combined collagen crosslinking and intrastromal corneal ring segment implantation.

PURPOSE: To evaluate the effectiveness of intracorneal riboflavin injection for combined collagen crosslinking (CXL) and intrastromal corneal ring segment (ICRS) implantation.

SETTING

Kudret Eye Hospital, Ankara, Turkey.

DESIGN

Noncomparative case series.

METHODS

Keratoconic eyes had combined ICRS (Intacs) implantation and transepithelial CXL with 20% alcohol application and riboflavin injection into the corneal channel. Outcome measures were uncorrected (UDVA) and corrected (CDVA) distance visual acuities, sphere, cylinder, and keratotomy (K) readings.

RESULTS

The study enrolled 131 eyes (105 patients) with a mean follow-up of 7.07 months ± 4.66 (SD). The mean improvement was 0.26 ± 0.16 logMAR in UDVA and 0.24 ± 0.16 logMAR in CDVA (both P<.05). The mean manifest spherical refraction decreased from -3.87 ± 4.55 diopters (D) to -1.25 ± 2.31 D, the mean manifest cylinder improved from -3.89 ± 1.97 D to -2.27 ± 2.18 D, and the mean K reading improved from 50.50 ± 5.26 D to 46.03 ± 4.51 D (all P<.05). There were no intraoperative or postoperative complications.

CONCLUSIONS

Combined ICRS and CXL treatment with intracorneal riboflavin injection was effective in keratoconic eyes. Intracorneal riboflavin injection into the tunnel was safe and may provide more penetration without epithelial removal.

FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.