Corneal collagen crosslinking with riboflavin and ultraviolet A to treat induced keratectasia after laser in situ keratomileusis

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Abstract
To determine whether riboflavin and ultraviolet-A (UVA) corneal crosslinking can be used as an alternative therapy to prevent the progression of keratectasia. Institute for Refractive and Ophthalmic Surgery, Zurich, Switzerland, and a private clinic, Athens, Greece. Corneal crosslinking was performed in 10 patients with formerly undiagnosed forme fruste keratoconus or pellucid marginal corneal degeneration who had laser in situ keratomileusis (LASIK) for myopic astigmatism and subsequently developed iatrogenic keratectasia. Surgery was performed in 1 eye per patient. Crosslinking induced by riboflavin and UVA arrested and/or partially reversed keratectasia over a postoperative follow-up of up to 25 months as demonstrated by preoperative and postoperative corneal topography and a reduction in maximum keratometric readings. Riboflavin-UVA corneal crosslinking increased the biomechanical stability of the cornea and may thus be a therapeutic means to arrest and partially reverse the progression of LASIK-induced iatrogenic keratectasia.