title: Isotonic riboflavin and HPMC with accelerated cross-linking protocol.
abstract: OBJECTIVE
  The aim of this study was to monitor corneal pachymetry changes during accelerated collagen cross-linking (CXL) for keratoconus while using isotonic riboflavin with HPMC.
  
  
  METHODS
  All consecutive patients who underwent CXL for progressive keratoconus, using accelerated protocol and isotonic riboflavin with HPMC, from December 2012 to September 2013 were included in the study. The corneal pachymetry measurements were obtained at different time points: after epithelial removal, after riboflavin application for 20 minutes, and after ultraviolet A irradiation for 10 minutes at 9 mW/cm.
  
  
  RESULTS
  A total of 14 eyes of 14 consecutive patients were included in this study. The mean age of the patients was 19 ± 8 years. There were 8 left eyes and 6 right eyes. After epithelial debridement, the thinnest pachymetric readings were between 324 and 452 μm (average, 401.4 ± 40.7 μm). No significant difference (P = 0.80) was found between the deepithelialized corneal thickness and after 20 minutes of isotonic riboflavin with HPMC (pachymetric average, 405.3 ± 37.5 μm). Pachymetric average after ultraviolet A irradiation was 419.29 ± 20.60 μm. There was no statistical significant change in the corneal thickness after the irradiation (P = 0.24).
  
  
  CONCLUSIONS
  During corneal CXL using isotonic riboflavin and HPMC with accelerated cross-linking protocol, no significant decline in the corneal thickness was demonstrated.
authors.affiliation: Department of Cornea and External Diseases, Advanced Eye Hospital and Institute, Navi Mumbai, India.
authors.forename: Vandana
authors.initials: V
authors.lastname: Jain
authors.forename: Zarine
authors.initials: Z
authors.lastname: Gazali
authors.forename: Rohan
authors.initials: R
authors.lastname: Bidayi
mesh_terms: D003094:Collagen / Q000378:metabolism; D003315:Cornea / Q000473:pathology; D063171:Corneal Pachymetry; D003319:Corneal Stroma / Q000378:metabolism; D019781:Corneal Topography; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D065347:Hypromellose Derivatives / Q000627:therapeutic use*; D007552:Isotonic Solutions; D007640:Keratoconus / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D012189:Retrospective Studies; D012256:Riboflavin / Q000627:therapeutic use*; D014466:Ultraviolet Rays; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D007552:Isotonic Solutions; D017319:Photosensitizing Agents; D065347:Hypromellose Derivatives; D003094:Collagen; D012256:Riboflavin