Open AccessEpithelium-on Corneal Collagen Cross-Linking with Hypotonic Riboflavin Solution in Progressive Keratoconus
Author(s) -
Kenneth A. Beckman
Publication year - 2021
Publication title -
clinical ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 56
eISSN - 1177-5483
pISSN - 1177-5467
DOI - 10.2147/opth.s318317
Subject(s) - keratoconus , medicine , keratometer , riboflavin , corneal collagen cross linking , ophthalmology , visual acuity , tonicity , cornea , chemistry , biochemistry
Epithelium-off cross-linking (epi-off CXL) has long been established as the gold standard treatment for progressive keratoconus. Several protocols for epithelium-on (epi-on) CXL have been proposed to help reduce post-operative pain and facilitate visual recovery, but there is no epi-on treatment approach that is currently approved in the United States. The hydrophilic and macromolecular characteristics of conventional epi-off riboflavin formulations may create clinical challenges for absorption through an intact epithelium. This study investigates the clinical efficacy of a dextran-free hypotonic riboflavin ophthalmic solution (Photrexa, Glaukos, Burlington, MA, USA), approved for epi-off CXL, in a novel epi-on CXL protocol.