title: Early confocal microscopy findings after cross-linking treatment.
abstract: OBJECTIVE
  To determine the effects of in vivo cross-linking treatment of the cornea.
  
  
  METHODS
  Eighteen eyes of eighteen keratoconus patients underwent cross-linking treatment using a 0.1% riboflavin solution and ultraviolet A radiation at 370 nm at 3 mW/cm² for 30 minutes. In vivo confocal microscopy was performed before, and at 1 week and 1 month after treatment.
  
  
  RESULTS
  At 1 week after treatment, keratocyte activation and collagen fiber organization showed as hyper-reflective structures and were observed from the first sub-epithelial image to a corneal stromal depth of 275.1 ± 85.9 μm. At 1 month after treatment, activated keratocytes and fiber organization were also observed from the first sub-epithelial image to a corneal stromal depth of 324.9 ± 66.0 μm. The deepest hyper-reflective structures at 1 month showed as thick, linear-shaped hyper-reflective structures.
  
  
  CONCLUSIONS
  In vivo confocal microscopy in humans showed corneal stromal changes at 1 week and 1 month after cross-linking treatment, in some cases at depths in excess of 300 μm.
authors.affiliation: Servicio de Córnea y Cirugía Refractiva, Asociación para Evitar la Ceguera en México, Hospital Luis Sánchez Bulnes, Universidad Nacional Autónoma de México, Mexico City, Mexico. mramirezf@medicasur.org.mx
authors.forename: M
authors.initials: M
authors.lastname: Ramírez
authors.forename: E
authors.initials: E
authors.lastname: Hernández-Quintela
authors.forename: R
authors.initials: R
authors.lastname: Naranjo-Tackman
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D003319:Corneal Stroma / Q000187:drug effects / Q000528:radiation effects; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D006801:Humans; D007640:Keratoconus / Q000628:therapy*; D018613:Microscopy, Confocal; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D012256:Riboflavin / Q000627:therapeutic use*; D014467:Ultraviolet Therapy; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D012256:Riboflavin