title: Clinical results with two different pharmaceutical preparations of riboflavin in corneal cross-linking: an 18-month follow up.
abstract: BACKGROUND
  Comparison of long-term clinical results of two different pharmaceutical formulations used in corneal cross-linking (CXL) in keratoconus patients.
  
  
  METHODS
  Sixty eyes of 60 keratoconus patients underwent CXL in two groups. We used riboflavin preparations from Sina Darou, Iran in group A, and Streuli Pharma, Switzerland in group B. Here we made inter-group comparison of changes in vision, refraction, Pentacam indices, corneal biomechanical indices, and endothelial cell count (ECC) 18 months after CXL.
  
  
  RESULTS
  Since four patients were lost to follow-up, 56 eyes (28 eyes in each group) were compared. Mean improvement in uncorrected visual acuity (UCVA) was 0.31 ± 0.65 LogMAR (P=0.014) in group A and 0.24 ± 0.62 LogMAR (P=0.082) in group B. Best corrected visual acuity (BCVA) remained quite unchanged in both groups (P=0.774). Mean spherical refractive error reduced by 0.45 ± 1.15 diopter (D) (P=0.041) in group A and 0.27 ± 1.73 D (P=0.458) in group B (P=0.655). Cylinder error and spherical equivalent had a similar trend without any change. Max-K (P=0.006) and mean-K (P=0.044) decreased significantly more in group A compared to group B. The reduction in CCT was significantly more in group A than group B (P=0.004). Q-value was quite unchanged in both groups (P=0.704). The inter-group difference in CH reduction was borderline significant statistically (P=0.057). Changes in corneal resistance factor and endothelial cell count were not significantly different between two groups (P=0.117 and P=0.229).
  
  
  CONCLUSIONS
  Clinical results of CXL with the domestic preparation of riboflavin are similar to that achieved with the Swiss made product in some aspects, and it is the preferred brand in some other aspects. This study will continue to report longer follow-up results.
  
  
  BACKGROUND
  IRCT201212034333N2.
authors.affiliation: Noor Ophthalmology Research Center, Noor Eye Hospital, No. 96 Esfandiar Blvd., Vali'asr Ave, Tehran, Iran. hhashemi@norc.ac.ir.
authors.forename: Hassan
authors.initials: H
authors.lastname: Hashemi
authors.affiliation: Noor Ophthalmology Research Center, Noor Eye Hospital, No. 96 Esfandiar Blvd., Vali'asr Ave, Tehran, Iran. masey1345@gmail.com.
authors.forename: Mohammad Amin
authors.initials: MA
authors.lastname: Seyedian
authors.affiliation: Noor Ophthalmology Research Center, Noor Eye Hospital, No. 96 Esfandiar Blvd., Vali'asr Ave, Tehran, Iran. miraftabm@gmail.com.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Miraftab
authors.affiliation: Noor Ophthalmology Research Center, Noor Eye Hospital, No. 96 Esfandiar Blvd., Vali'asr Ave, Tehran, Iran. hoomanbh@yahoo.com.
authors.forename: Hooman
authors.initials: H
authors.lastname: Bahrmandy
authors.affiliation: Noor Ophthalmology Research Center, Noor Eye Hospital, No. 96 Esfandiar Blvd., Vali'asr Ave, Tehran, Iran. araz_green@yahoo.com.
authors.forename: Araz
authors.initials: A
authors.lastname: Sabzevari
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, International Campus (TUMS-IC), Tehran, Iran. soheilaasgari@gmail.com.
authors.forename: Soheila
authors.initials: S
authors.lastname: Asgari
mesh_terms: D000328:Adult; D002626:Chemistry, Pharmaceutical; D003432:Cross-Linking Reagents / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007492:Iran; D007640:Keratoconus / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D012029:Refraction, Ocular / Q000187:drug effects; D012256:Riboflavin / Q000008:administration & dosage* / Q000627:therapeutic use; D013557:Switzerland; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D012256:Riboflavin