1. Three-Year Study Results of Trans-epithelial Corneal Collagen Crosslinking for Keratoconus Brian S. Boxer Wachler, M.D. Lorelei L. Vicente, M.D. BEVERLY HILLS, CA

2. Disclosure Financial declaration/conflict of interest: Dr. Boxer Wachler is consultant to Addition Technology and Staar Surgical. Dr. Vicente has no financial interest in the subject matter of this paper.

3. Purpose To analyze long-term results of patients with keratoconus who had trans-epithelial corneal collagen crosslinking for ectasia.

4. Methods 7 eyes of 4 patients Mean age: 39 +/- 11 years Trans-epithelial Crosslinking using 0.1 % riboflavin with 0.5% carboxymethylcellulose (RF-CMC) and Tetracaine

5. Methods Comparison of baseline and follow-up exam of visual parameters after 3 years –UCVA –BCVA –Manifest spherical equivalent (SE) –Refractive cylinder –Topography (NIDEK ARK-9000 OPD- SCAN Refractive Power/Corneal Analyser (Marco, Jacksonville, FL)

6. Trans-Epithelial Crosslinking Pretreatment with Tetracaine and RF-CMC Instilled one drop after another every 5 minutes for 15 minutes Trans-Epithelial Crosslinking Protocol RF-CMC (q 3 min.) & Tetracaine (q 10 min.) for 30 mins. Applied via soppy, wet surgical sponges (Merocel eye spears, Medtronic, Jacksonville, FL ) Ultraviolet-A light (3.0 mW/cm 2 at 370 nm)

7. Results

9. Conclusion Preoperative visual parameters remained stable after Trans-Epithelial Crosslinking with 0.1% riboflavin w/ 0.5% CMC (RF-CMC)