title: Effect of cross-linking on corneal thickness in patients with corneal edema.
abstract: OBJECTIVE
  To investigate the pachymetric changes of collagen cross-linking in corneas with edema because of endothelial dysfunction.
  
  
  METHODS
  Interventional case series included 25 eyes of 25 consecutive patients with corneal edema for at least 4 months related to Fuchs endothelial dystrophy, corneal graft failure, and postoperative bullous keratopathy. Central corneal thickness was measured preoperatively, 1, 3, and 6 months after the procedure by ultrasound pachymetry and optical coherence tomography.
  
  
  RESULTS
  Mean central corneal thickness measured by ultrasound pachymetry decreased after corneal cross-linking (mean +/- SD): 712.0 +/- 99.7, 618.3 +/- 103.0, and 657.5 +/- 114.8 for preoperative, 1-, and 3-month follow-up, respectively. Differences between preoperative value and 1- and 3-month follow-up values were statistically significant (P < 0.01). Similar results were found with the optical coherence tomography (mean +/- SD): 777.3 +/- 131.0, 711.6 +/- 133.1, 746.4 +/- 142.4, and 830.6 +/- 198.7, for preoperative, 1-, 3-, and 6-month follow-up values, respectively. Fourteen patients (56%) developed new epithelial bullae after 3 months; 11 patients (44%) remained asymptomatic until their last visit.
  
  
  CONCLUSIONS
  Corneal cross-linking showed to be a safe procedure and potential therapeutic alternative for the treatment of corneal edema.
authors.affiliation: Cornea and External Diseases Division, Instituto da Visão, Federal University of Sao Paulo, Sao Paulo, Brazil. mmvcb@hotmail.com
authors.forename: Manuela M V
authors.initials: MM
authors.lastname: Cordeiro Barbosa
authors.forename: José Bonifácio
authors.initials: JB
authors.lastname: Barbosa
authors.forename: Flavio E
authors.initials: FE
authors.lastname: Hirai
authors.forename: Ana Luisa
authors.initials: AL
authors.lastname: Hofling-Lima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003094:Collagen / Q000378:metabolism*; D003315:Cornea / Q000000981:diagnostic imaging / Q000473:pathology*; D015715:Corneal Edema / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D003319:Corneal Stroma / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D012256:Riboflavin / Q000627:therapeutic use; D041623:Tomography, Optical Coherence; D014463:Ultrasonography; D014466:Ultraviolet Rays; D055815:Young Adult
chemical_list: D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin