Corneal Healing After Riboflavin Ultraviolet-A Collagen Cro-Linking Determined by Confocal Laer canning Microcopy In Vivo: Early and Late Modification Original Reearch Article

Purpoe To ae early and late micromorphological modification of cro-linked cornea in vivo by mean of Heidelberg Retinal Tomography (HRT) II confocal microcopy. Deign Propective nonrandomized open trial. Method Micromorphological examination of 44 cro-linked keratoconic cornea wa performed in vivo by HRT II confocal laer canning microcopy. Riboflavin ultraviolet (UV)-A–induced corneal collagen cro-linking (CXL) wa performed according to the iena protocol: pilocarpin 1% drop 30 minute before, topical anetheia with lidocaine 4% drop 15 minute before irradiation, mechanical craping of epithelium (9-mm-diameter area), preirradiation oaking for 10 minute in riboflavin olution 0.1% (Ricrolin, ooft, Italy) applied every 2.5 minute for 30 minute, 30 minute expoure to olid-tate UVA illuminator (Caporoi; Baiocchi; Mazzotta, X-linker, CO, Italy), 8-mm-diameter irradiated area, energy delivered 3 mW/cm2. All patient were examined by confocal can preoperatively and at the following time after treatment: one, three, and ix month, and one, two, and three year. Reult No damage to the limbal region wa oberved. Epithelial regrowth wa complete after four day of oft contact len bandage. The anatomy of the ubepithelial plexu wa retored one year after the operation with full corneal enitivity. Increaed denity of extracellular matrix in late potoperative period indicated cro-linked collagen to a depth of 340 μm expreed by a late demarcation line. Concluion In vivo confocal microcopy howed early and late modification of corneal microtructure after the treatment. The three-year tability of CXL recorded could be related to increaed cro-link formation, ynthei of well-tructured collagen and new lamellar interconnection.