title: Corneal collagen cross-linking with hypoosmolar riboflavin solution in keratoconic corneas.
abstract: OBJECTIVE
  To report the 12-month outcomes of corneal collagen cross-linking (CXL) with a hypoosmolar riboflavin and ultraviolet-A (UVA) irradiation in thin corneas.
  
  
  METHODS
  Eight eyes underwent CXL using a hypoosmolar riboflavin solution after epithelial removal. The corrected distance visual acuity (CDVA), manifest refraction, the mean thinnest corneal thickness (MTCT), and the endothelial cell density (ECD) were evaluated before and 6 and 12 months after CXL.
  
  
  RESULTS
  The MTCT was 413.9 ± 12.4 μm before treatment and reduced to 381.1 ± 7.3 μm after the removal of the epithelium. After CXL, the thickness decreased to 410.3 ± 14.5 μm at the last follow-up. Before treatment, the mean K-value of the apex of the keratoconus corneas was 58.7 ± 3.5 diopters and slightly decreased (57.7 ± 4.9 diopters) at 12 months. The mean CDVA was 0.54 ± 0.23 logarithm of the minimal angle of resolution before treatment and increased to 0.51 ± 0.21 logarithm at the last follow-up. The ECD was 2731.4 ± 191.8 cells/mm(2) before treatment and was 2733.4 ± 222.6 cells/mm(2) at 12 months after treatment.
  
  
  CONCLUSIONS
  CXL with a hypoosmolar riboflavin in thin corneas seems to be a promising method for keratoconic eyes with the mean thinnest corneal thickness less than 400 μm without epithelium.
authors.affiliation: Department of Ophthalmology, Shandong Provincial Hospital, Shandong University, No. 324, Jing 5 Road, Huaiyin District, Jinan, Shandong 250021, China.
authors.forename: Shaofeng
authors.identifier: 0000-0003-4270-8958
authors.initials: S
authors.lastname: Gu
authors.affiliation: Department of Ophthalmology, Shandong Provincial Hospital, Shandong University, No. 324, Jing 5 Road, Huaiyin District, Jinan, Shandong 250021, China.
authors.forename: Zhaoshan
authors.initials: Z
authors.lastname: Fan
authors.affiliation: Department of Ophthalmology, Shandong Provincial Hospital, Shandong University, No. 324, Jing 5 Road, Huaiyin District, Jinan, Shandong 250021, China.
authors.forename: Lihua
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Ophthalmology, Shandong Provincial Hospital, Shandong University, No. 324, Jing 5 Road, Huaiyin District, Jinan, Shandong 250021, China.
authors.forename: Xiangchen
authors.initials: X
authors.lastname: Tao
authors.affiliation: Department of Ophthalmology, Shandong Provincial Hospital, Shandong University, No. 324, Jing 5 Road, Huaiyin District, Jinan, Shandong 250021, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Ophthalmology, Shandong Provincial Hospital, Shandong University, No. 324, Jing 5 Road, Huaiyin District, Jinan, Shandong 250021, China.
authors.forename: Guoying
authors.initials: G
authors.lastname: Mu
mesh_terms: D000328:Adult; D002452:Cell Count; D003094:Collagen / Q000378:metabolism*; D003315:Cornea / Q000187:drug effects / Q000378:metabolism* / Q000473:pathology; D063171:Corneal Pachymetry; D003432:Cross-Linking Reagents / Q000378:metabolism*; D042783:Endothelial Cells / Q000187:drug effects / Q000473:pathology; D019573:Epithelium, Corneal / Q000187:drug effects / Q000473:pathology; D005260:Female; D006801:Humans; D007038:Hypotonic Solutions / Q000494:pharmacology / Q000627:therapeutic use*; D007640:Keratoconus / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D012256:Riboflavin / Q000494:pharmacology / Q000627:therapeutic use*; D012996:Solutions; D014792:Visual Acuity
chemical_list: D003432:Cross-Linking Reagents; D007038:Hypotonic Solutions; D012996:Solutions; D003094:Collagen; D012256:Riboflavin