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Corneal stromal depth of the demarcation line in ‘accelerated corneal cross-linking’ with different concentrations of riboflavin solutions

  • Dilay Ozek
  • Ozlem Evren Kemer
  • Pinar Altiaylik Ozer
Original Paper

Abstract

Purpose

The aim of this study is to compare the effect of different riboflavin solutions (hypotonic and isotonic) used during accelerated corneal cross-linking (CXL) on the mean depth of the demarcation line (DDL) formed in corneal stroma.

Methods

This prospective, cross-sectional study included 38 eyes of 26 patients. All patients underwent accelerated CXL due to progressive keratoconus. When the corneal epithelium was removed, 17 eyes of 12 patients with corneal thickness < 400 µm were categorized as Group 1, and 21 eyes of 14 patients with corneal thickness > 400 µm as Group 2. Hypotonic riboflavin was applied to Group 1 patients, and isotonic riboflavin to Group 2 patients. Anterior segment optical coherence tomography was performed on all patients by two independent observers at the end of the first and third months.

Result

Group 1 included 5 male and 7 female patients with an average age of 25.1 ± 8.0 years, whereas Group 2 included 7 male and 7 female patients with an average age of 31.8 ± 10.12 years. At the end of the first month, the mean DDL in Group 1 and Group 2 was 180.32 ± 10.26 and 287.21 ± 15.01 µm, respectively. This difference was statistically significant (p < 0.05).

Conclusion

Application of different riboflavin solutions was observed to have an effect on measured corneal thickness after saturation and the depth of the demarcation line. The use of hypotonic riboflavin results in swelling of the cornea and more superficial localization of the stromal demarcation line after CXL.

Keywords

Keratoconus Accelerated corneal cross-linking Riboflavin Demarcation line 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

The study was conducted in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

It was obtained from all individual participants included in the study.

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Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  1. 1.Department of OphthalmologyAnkara Numune Education and Research HospitalAnkaraTurkey
  2. 2.Department of Ophthalmology, Faculty of MedicineUfuk UniversityAnkaraTurkey
  3. 3.AnkaraTurkey

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