A Prospective, Comparative, Clinical Study to Evaluate the Safety and Efficacy of Two Different 0.1% Riboflavin Solutions Used in Collagen Crosslinking Treatment for Patients with Keratoconus

Sheetal Brar, Sri Ganesh, Shilpa S Reddy, Nagesh BN, Dhwni Shahanand Department of Phaco-Refractive Surgery, Nethradhama Superspecialty Eye Hospital, Bangalore, Karnataka, IndiaCorrespondence: Sheetal BrarNethradhama Superspeciality Eye Hospital, 256/14, Kanakapura Main Road, 7th Block, Jayanagar, B...

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Autores principales:	Brar S, Ganesh S, Reddy SS, BN N, Shahanand D
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	keratoconus collagen cross linking cxl riboflavin flavin peschke Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/bb6cbf2b938e480c93e55f7f66d52a38
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spelling	oai:doaj.org-article:bb6cbf2b938e480c93e55f7f66d52a382021-12-02T17:07:17ZA Prospective, Comparative, Clinical Study to Evaluate the Safety and Efficacy of Two Different 0.1% Riboflavin Solutions Used in Collagen Crosslinking Treatment for Patients with Keratoconus1177-5483https://doaj.org/article/bb6cbf2b938e480c93e55f7f66d52a382021-06-01T00:00:00Zhttps://www.dovepress.com/a-prospective-comparative-clinical-study-to-evaluate-the-safety-and-ef-peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Sheetal Brar, Sri Ganesh, Shilpa S Reddy, Nagesh BN, Dhwni Shahanand Department of Phaco-Refractive Surgery, Nethradhama Superspecialty Eye Hospital, Bangalore, Karnataka, IndiaCorrespondence: Sheetal BrarNethradhama Superspeciality Eye Hospital, 256/14, Kanakapura Main Road, 7th Block, Jayanagar, Bengaluru, Karnataka, 560070, IndiaTel +919591002092Email brar_sheetal@yahoo.co.inPurpose: To compare the safety and efficacy of 0.1% riboflavin in two different solutions which is used in corneal collagen crosslinking (CXL) for the treatment of keratoconus.Methods: This was a prospective, randomized, comparison study which included 100 eyes of 61 patients with progressive keratoconus who underwent CXL with riboflavin 0.1% solution as a photosensitizer, using the standard Dresden protocol of using 3mW/cm2 UV-A irradiation for 30 minutes which corresponds to a total energy of 5.4 J/cm2. The recruited patients were divided into 2 groups ie, Flavin Group and Peschke-D group by computer generated randomization. Postoperative examinations were conducted on 1 day, 1 month, 3 months, 6 months and 12 months after the crosslinking.Results: For both groups, the mean manifest spherical equivalent (SE), astigmatism, best corrected distance visual acuity, keratometry values, thinnest pachymetry values, demarcation line depth and endothelial cell density preoperatively and at postoperative 12 months were comparable with no statistically significant differences. At 12 months postoperatively, 62% of eyes in the Flavin group, and 68% of eyes in the Peschke-D group had postoperative manifest SE of within ± 1.00 D. During UV-A exposure, the cornea in the Flavin group showed intraoperative thinning of 112 microns (27%) as compared with a thinning of 108.12 microns (26.5%) observed in the Peschke group (p=1.67) from the initial pachymetry readings. No eye in either group had any immediate or long-term postop vision threatening complications such as infectious keratitis, corneal melt, non-resolving corneal oedema or endothelial decompensation.Conclusion: Both riboflavin solutions were equally safe and effective in the management of progressive keratoconus, and resulted in similar changes in terms of mean manifest spherical equivalent (SE), astigmatism, best corrected distance visual acuity, keratometry values, thinnest pachymetry values, demarcation line depth and endothelial cell density at the end of 12 months postoperatively.Trial Registration Number: Ctri/2019/11/021841 (Www.ctri.nic.in).Keywords: keratoconus, collagen cross linking, CXL, riboflavin, Flavin, PeschkeBrar SGanesh SReddy SSBN NShahanand DDove Medical Pressarticlekeratoconuscollagen cross linkingcxlriboflavinflavinpeschkeOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 2607-2617 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	keratoconus collagen cross linking cxl riboflavin flavin peschke Ophthalmology RE1-994
spellingShingle	keratoconus collagen cross linking cxl riboflavin flavin peschke Ophthalmology RE1-994 Brar S Ganesh S Reddy SS BN N Shahanand D A Prospective, Comparative, Clinical Study to Evaluate the Safety and Efficacy of Two Different 0.1% Riboflavin Solutions Used in Collagen Crosslinking Treatment for Patients with Keratoconus
description	Sheetal Brar, Sri Ganesh, Shilpa S Reddy, Nagesh BN, Dhwni Shahanand Department of Phaco-Refractive Surgery, Nethradhama Superspecialty Eye Hospital, Bangalore, Karnataka, IndiaCorrespondence: Sheetal BrarNethradhama Superspeciality Eye Hospital, 256/14, Kanakapura Main Road, 7th Block, Jayanagar, Bengaluru, Karnataka, 560070, IndiaTel +919591002092Email brar_sheetal@yahoo.co.inPurpose: To compare the safety and efficacy of 0.1% riboflavin in two different solutions which is used in corneal collagen crosslinking (CXL) for the treatment of keratoconus.Methods: This was a prospective, randomized, comparison study which included 100 eyes of 61 patients with progressive keratoconus who underwent CXL with riboflavin 0.1% solution as a photosensitizer, using the standard Dresden protocol of using 3mW/cm2 UV-A irradiation for 30 minutes which corresponds to a total energy of 5.4 J/cm2. The recruited patients were divided into 2 groups ie, Flavin Group and Peschke-D group by computer generated randomization. Postoperative examinations were conducted on 1 day, 1 month, 3 months, 6 months and 12 months after the crosslinking.Results: For both groups, the mean manifest spherical equivalent (SE), astigmatism, best corrected distance visual acuity, keratometry values, thinnest pachymetry values, demarcation line depth and endothelial cell density preoperatively and at postoperative 12 months were comparable with no statistically significant differences. At 12 months postoperatively, 62% of eyes in the Flavin group, and 68% of eyes in the Peschke-D group had postoperative manifest SE of within ± 1.00 D. During UV-A exposure, the cornea in the Flavin group showed intraoperative thinning of 112 microns (27%) as compared with a thinning of 108.12 microns (26.5%) observed in the Peschke group (p=1.67) from the initial pachymetry readings. No eye in either group had any immediate or long-term postop vision threatening complications such as infectious keratitis, corneal melt, non-resolving corneal oedema or endothelial decompensation.Conclusion: Both riboflavin solutions were equally safe and effective in the management of progressive keratoconus, and resulted in similar changes in terms of mean manifest spherical equivalent (SE), astigmatism, best corrected distance visual acuity, keratometry values, thinnest pachymetry values, demarcation line depth and endothelial cell density at the end of 12 months postoperatively.Trial Registration Number: Ctri/2019/11/021841 (Www.ctri.nic.in).Keywords: keratoconus, collagen cross linking, CXL, riboflavin, Flavin, Peschke
format	article
author	Brar S Ganesh S Reddy SS BN N Shahanand D
author_facet	Brar S Ganesh S Reddy SS BN N Shahanand D
author_sort	Brar S
title	A Prospective, Comparative, Clinical Study to Evaluate the Safety and Efficacy of Two Different 0.1% Riboflavin Solutions Used in Collagen Crosslinking Treatment for Patients with Keratoconus
title_short	A Prospective, Comparative, Clinical Study to Evaluate the Safety and Efficacy of Two Different 0.1% Riboflavin Solutions Used in Collagen Crosslinking Treatment for Patients with Keratoconus
title_full	A Prospective, Comparative, Clinical Study to Evaluate the Safety and Efficacy of Two Different 0.1% Riboflavin Solutions Used in Collagen Crosslinking Treatment for Patients with Keratoconus
title_fullStr	A Prospective, Comparative, Clinical Study to Evaluate the Safety and Efficacy of Two Different 0.1% Riboflavin Solutions Used in Collagen Crosslinking Treatment for Patients with Keratoconus
title_full_unstemmed	A Prospective, Comparative, Clinical Study to Evaluate the Safety and Efficacy of Two Different 0.1% Riboflavin Solutions Used in Collagen Crosslinking Treatment for Patients with Keratoconus
title_sort	prospective, comparative, clinical study to evaluate the safety and efficacy of two different 0.1% riboflavin solutions used in collagen crosslinking treatment for patients with keratoconus
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/bb6cbf2b938e480c93e55f7f66d52a38
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A Prospective, Comparative, Clinical Study to Evaluate the Safety and Efficacy of Two Different 0.1% Riboflavin Solutions Used in Collagen Crosslinking Treatment for Patients with Keratoconus

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