Crosslinking prior to intracorneal ring insertion may not provide any benefit

This prospective randomized study investigated whether there was any benefit to performing corneal crosslinking (CXL) prior to intrastromal corneal ring segment (ICRS) insertion. The authors report in the May issue of the American Journal of Ophthalmology that, based on the protocol followed in the study, crosslinking before ICRS placement does not seem to augment the effect of ICRS. They found no difference 24 months after ICRS insertion, with or without prior CXL, in terms of refractive, topographic, pachymetric, tonometric and corneal biomechanical results.

The study included 31 patients (39 eyes) randomized to corneal CXL with riboflavin and ultraviolet A (UVA) light, or only riboflavin 0.1% (w/v) eye drops 20% dextran solution for one month without epithelial removal. After three months, all patients underwent ICRS insertion.

There was no statistical difference between the groups in UCVA or BSCVA at baseline or at 24 months after ICRS insertion. Also, there were no statistical differences between the groups at 24 months for all three topographic parameters: flattest-K1 (P = 0.81), steepest-K2 (P = 0.68) and average keratometry (mean power; P = 0.52).