title: Riboflavin injection into the corneal channel for combined collagen crosslinking and intrastromal corneal ring segment implantation.
abstract: OBJECTIVE
  To evaluate the effectiveness of intracorneal riboflavin injection for combined collagen crosslinking (CXL) and intrastromal corneal ring segment (ICRS) implantation.
  
  
  METHODS
  Kudret Eye Hospital, Ankara, Turkey.
  
  
  METHODS
  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.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: Dünya Eye Hospital (Kılıç), Istanbul, Turkey. aylinkiliedr@gmail.com
authors.forename: Aylin
authors.initials: A
authors.lastname: Kılıç
authors.forename: Gunhal
authors.initials: G
authors.lastname: Kamburoglu
authors.forename: Arsen
authors.initials: A
authors.lastname: Akıncı
mesh_terms: D003094:Collagen / Q000378:metabolism*; D003131:Combined Modality Therapy; D003319:Corneal Stroma / Q000187:drug effects / Q000378:metabolism / Q000601:surgery*; D019781:Corneal Topography; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D012256:Riboflavin / Q000627:therapeutic use*; D016896:Treatment Outcome; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin