title: Transepithelial corneal collagen cross-linking by iontophoresis of riboflavin.
abstract: OBJECTIVE
  To evaluate the effectiveness of transepithelial cornea impregnation with riboflavin 0.1% by iontophoresis for collagen cross-linking.
  
  
  METHODS
  Transepithelial collagen cross-linking by iontophoresis of riboflavin was performed in a series of 22 eyes of 19 patients with progressive keratoconus I-II of Amsler classification. The riboflavin solution was administered by iontophoresis for 10 min in total, after which standard surface UVA irradiation (370 nm, 3 mW/cm(2) ) was performed at a 5-cm distance for 30 min.
  
  
  RESULTS
  The riboflavin/UVA treatment resulted in a decrease in the average keratometry level from 46.47 ± 1.03 to 44.12 ± 1.12 D 1 year after the procedure. Corneal astigmatism decreased from 3.44 ± 0.48 to 2.95 ± 0.23 D. Uncorrected distance visual acuity improved from 0.61 ± 0.44 up to 0.48 ± 0.41 (LogMAR). Preoperative and postoperative endothelial cell density remained unchanged at 2765 ± 21.15 cells/mm(2) .
  
  
  CONCLUSIONS
  Transepithelial collagen cross-linking by iontophoresis might become an effective method for riboflavin impregnation of the corneal stroma reducing the duration of the procedure and being more comfortable for the patients. Further long-term studies are necessary to complete the evaluation of the efficacy and risk spectrum of the modified cross-linking technique.
authors.affiliation: Ufa Eye Research Institute, Ufa, RussiaDepartment of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Guzel
authors.initials: G
authors.lastname: Bikbova
authors.forename: Mukharram
authors.initials: M
authors.lastname: Bikbov
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000503:physiopathology; D003094:Collagen / Q000378:metabolism*; D063171:Corneal Pachymetry; D003319:Corneal Stroma / Q000378:metabolism; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D019573:Epithelium, Corneal / Q000187:drug effects; D005260:Female; D006801:Humans; D007478:Iontophoresis / Q000379:methods*; D007640:Keratoconus / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D018613:Microscopy, Confocal; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D012029:Refraction, Ocular / Q000502:physiology; D012256:Riboflavin / Q000627:therapeutic use*; D041623:Tomography, Optical Coherence; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin
keywords: cross-linking; iontophoresis; keratoconus; riboflavin