Long-term efficacy of retention ring-assisted continuous riboflavin application in pulsed-light accelerated corneal collagen cross-linking in keratoconus

초록

Purpose : To investigate long-term efficacy and safety of 10-minute continuous application of 0.1% riboflavin using retention ring in pulsed-light accelerated corneal collagen cross-linking on the progression of keratoconus. Methods : The medical records of 18 eyes of 16 patients with progressive keratoconus who underwent collagen cross-linking at Seoul National University Hospital between 2016 and 2019 were retrospectively reviewed. The patients who were followed-up for more than 3 years were included. Isotonic 0.1% riboflavin was continuously applied for 10 minutes using retention ring in the accelerated cross-linking protocol. Success rate on halting progression of keratoconus, changes of visual acuity, refractive error, topographic indices, central corneal thickness, and endothelial cell density were measured every 12 months for 3 years, and data were compared with the baseline parameters. Results : Overall success rate was 94.4%. Best corrected visual acuity (logMAR) was significantly improved from preoperative 0.44 to postoperative 0.22 at 3 years (p = 0.04). Maximum keratometry decreased from 52.5 D to 50.4 D (p = 0.005) and corneal astigmatism decreased from 5.8 D to 4.7 D (p = 0.08). Central corneal thickness and endothelial cell density did not significantly change through 3 years. Conclusions : It suggests that long-term outcome of retention ring-assisted 10-minute continuous riboflavin application in pulsed-light accelerated cross-linking is effective and safe on seizing the progression of keratoconus, and it seems to be comparable with the outcome of conventional Dresden protocol as previous reported.