title: Six-month outcomes of corneal crosslinking with dextran-free isotonic riboflavin solution.
abstract: OBJECTIVE
  To analyze the short-term clinical and topographic outcomes in patients with keratoconus after corneal collagen cross-linking treatment (CXL) with dextran-free isotonic riboflavin solution.
  
  
  METHODS
  In this retrospective case series, 26 eyes from 26 patients with keratoconus were studied. The best corrected visual acuity (BCVA) and refractive and topographic findings were analyzed at a 6-month follow-up.
  
  
  RESULTS
  The mean BCVA (Snellen lines) values before and 1, 3, and 6 months after CXL were 0.51 ± 0.2, 0.48 ± 0.2, 0.57 ± 0.2, and 0.64 ± 0.2, respectively, and the difference between the preoperative and 6-month values was statistically significant (p=0.006). The mean spherical equivalent refraction decreased from -5.6 ± 2.4 diopters (D) preoperatively to -5.0 ± 2.1 D, and mean simulated keratometry decreased from 48.5 ± 2.5 D to 47.8 ± 2.6 D at 6 months. (p=0.145 and p=0.001, respectively). In addition, the maximum keratometry decreased progressively and significantly from the preoperative value during follow-up (p=0.003). The central and minimal corneal thicknesses, including those of the epithelium, also decreased from 442.8 ± 25.6 µm and 430.5 ± 23.9 µm preoperatively to 420.7 ± 31.8 µm and 409.3 ± 28.7 µm at the most recent follow-up (p<0.001), respectively. No intraoperative or postoperative complications were observed.
  
  
  CONCLUSIONS
  CXL with dextran-free isotonic riboflavin solution appears to be a safe treatment alternative for keratoconus and yields sustained short-term improvements in visual acuity, keratometric readings, and corneal thickness. However, long-term results are needed to confirm these outcomes.
authors.affiliation: Department of Ophthalmology, Meran Faculty of Medicine, Konya, Turkey.
authors.forename: Refik
authors.initials: R
authors.lastname: Oltulu
authors.affiliation: Department of Ophthalmology, Meran Faculty of Medicine, Konya, Turkey.
authors.forename: Gunhal
authors.initials: G
authors.lastname: Satirtav
authors.affiliation: Department of Ophthalmology, Meran Faculty of Medicine, Konya, Turkey.
authors.forename: Meryem
authors.initials: M
authors.lastname: Donbaloglu
authors.affiliation: Department of Ophthalmology, Meran Faculty of Medicine, Konya, Turkey.
authors.forename: Mehmet Kemal
authors.initials: MK
authors.lastname: Gunduz
authors.affiliation: Department of Ophthalmology, Meran Faculty of Medicine, Konya, Turkey.
authors.forename: Hurkan
authors.initials: H
authors.lastname: Kerimoglu
authors.affiliation: Department of Ophthalmology, Meran Faculty of Medicine, Konya, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Okka
authors.affiliation: Department of Ophthalmology, Meran Faculty of Medicine, Konya, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ozkagnici
authors.affiliation: Biostatistics Unit, Department of Medical Education and Informatics, Meran Faculty of Medicine, Konya, Turkey.
authors.forename: Adnan
authors.initials: A
authors.lastname: Karaibrahimoglu
mesh_terms: D000293:Adolescent; D000328:Adult; D003315:Cornea / Q000187:drug effects* / Q000473:pathology; D019781:Corneal Topography; D003432:Cross-Linking Reagents / Q000494:pharmacology / Q000627:therapeutic use*; D003911:Dextrans; D005260:Female; D006801:Humans; D007552:Isotonic Solutions; D007640:Keratoconus / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D017319:Photosensitizing Agents / Q000494:pharmacology / Q000627:therapeutic use*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012256:Riboflavin / Q000494:pharmacology / Q000627:therapeutic use*; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D003911:Dextrans; D007552:Isotonic Solutions; D017319:Photosensitizing Agents; D012256:Riboflavin