KERATOCONUS AND EPI-OFF CORNEAL CROSS-LINKING BY RIBOFLAVIN-ULTRAVIOLET TYPE A: INDICATIONS AND RATIONAL OF EMPLOYMENT

Keratoconus is the most common dystrophic corneal ectasia, characterized by the presence of irregular astigmatism associated with a reduction of corneal thickness. It is the leading cause of corneal transplant in Italy and Europe. Recently a new therapeutic opportunity is offered by Riboflavin + UV A Corneal Cross-linking, first introduced in Italy in 2004 by Professor Aldo Caporossi at the Department of Ophthalmology of Siena. This treatment requires early diagnosis to prevent corneal ectatic modifications related to pathology. The modern treatment of keratoconus is directed into three "directories": 1) prevention of its progression; 2) reduction of the related refractive defect and induced corneal aberrations; 3) replacement of ectatic corneal in advanced phase not subjected to conservative approach and HRGP lens intolerance. Riboflavin + UV A Collagen Cross-linking is mostly indicated in patients between 10 and 26 years old with progressive keratoconus (stage 1 and 2) with strict adherence to the recommended inclusion thickness (thinnest point > 400 microns).