Epithelium removal not necessary for collagen cross-linking

Corneal collagen cross-linking with riboflavin, without removing the epithelium, is both safe and effective, according to Roberto Pinelli, ILMO, Brescia, Italy.

Dr Pinelli examined two groups of five keratoconic patients. Group A was treated monocularly without removing the epithelium and Group B was treated after epithelial removal. Custom-made riboflavin eye-drops were applied to the cornea and activated by UV-A.

Dr Pinelli noted no significant differences between the two groups postoperatively. The 30 eyes in Group A, at 18 months follow-up, showed a mean K reduction of 0.83 D, higher K reduction in the 3 mm central zone, a mean uncorrected visual acuity (UCVA) improvement of 1.3 lines, a mean best spectacle corrected visual acuity (BSCVA) and an increase in central pachymetry. Furthermore, keratoconus progression was halted in all eyes.

These results demonstrate that it is not necessary to remove the epithelium in order for riboflavin to effectively penetrate the cornea.