ABSTRACT
To evaluate the effectiveness of corneal cross-linking in improving the signs and symptoms of bullous keratopathy. This prospective non-randomized case series evaluated 20 eyes with bullous ketratopathy that underwent corneal cross-linking [C3R] with riboflavin and ultraviolet-A [UVA, 370 nm, 3 mW/cm 2]. C3R was performed for 30 min in a routine procedure after removal of epithelium. Central corneal thickness [CCT], corneal haze, visual acuity [VA], and the presence of irritating symptoms were recorded before the procedure, and at 1 week, 1 month, 3 months, and 6 months after the procedure. The mean CCT was 872 +/- 162 micro m [range: 665-1180 micro m] before the procedure. Following the procedure, CCT was 855 +/- 175 micro m after 1 week, 839 +/- 210 micro m after 1 month, 866 +/- 185 micro m after 3 months, and 863 +/- 177 micro m after 6 months [P>0.05, all visits]. There was no significant improvement in VA or corneal clarity after 6 months. Improvement of the following symptoms: burning, pain, and foreign body sensation were reported after 6 months by 83.3%, 75.0%, and 66.7% of patients, respectively. Persistent epithelial defect occurred in five patients [25%] resolved with frequent lubrication and bandage contact lenses. The outcomes of this study indicate corneal cross-linking is not an effective treatment for bullous keratopathy with respect to VA and CCT, although it can improve irritation and discomfort