Epi-off riboflavin with vitamin E TPGS (Ribocross®) cross-linking: one-year outcome

To assess the short and mid-term outcomes of epithelium-off (epi-off) corneal collagen cross-linking using Riboflavin with Vitamin E TPGS (Epi-off Ribocross® CXL) for progressive keratoconus (KC).

Retrospective, single-center non-comparative interventional study.

Patients with progressive keratoconus who underwent CXL using (Epi-off Ribocross® CXL) from May 2021 to May 2022 who completed at least 12 months of follow-up in Humanitas Clinical and Research Center, Rozzano, Milan, Italy. Corrected distance visual acuity with spectable (CDVA), tomographic parameters (Belin ABCD) and topographic parameters were evaluated at baseline and at last follow up.

Twenty eyes of twenty patients fulfilled inclusion criteria. CDVA remained stable at last follow up (0.88 ± 0.19 from 0.83 ± 0.21, p = 0.45) with a significant reduction in cylinder (1.97 ± 1.69 from 2.78 ± 2.19, p = 0.03). Kmax significantly improved from 53.18D ± 6.32 to 50.96 ± 5.3D (p = 0.005). At the last follow up, no case of progression was noted.

Epi-off Ribocross® CXL proved to be a safe treatment for progressive KC, with a stabilization of all cases at the one year follow up. Further studies are needed to confirm long-term stability.