Riboflavin for corneal collagen cross-linking


Most of the clinical research evaluating outcomes of treatment for keratoconus is limited mainly owing to two reasons: 1. low sample size, and 2. short follow-up period. The Save Sight Keratoconus registry (SSKR) is a growing multinational database established in 2015, which currently consists of more than 21,000 clinical visit data for about 4500 eyes (of approximately 2500 patients) with keratoconus. This study involves conducting a comprehensive literature review, and analysing the SSKR data to explore the role of riboflavin variants on the outcomes of corneal cross-linking. Knowledge of descriptive statistics and skills on the R programming language is desired.


Professor Stephanie Watson, Dr Himal Kandel

Research Location

Camperdown - Central Clinical School - Save Sight Institute

Program Type



Keratoconus is a chronic, progressive corneal disorder which typically has an onset in early adolescence. In keratoconus eye, collagen which supports cornea becomes weak leading to a conical protrusion, which further leads to visual impairment and reduction in quality-of-life. Treatment methods of keratoconus include corneal surgical procedures such as intracorneal rings and photo-refractive keratectomy, which aim to correct the associated refractive error in keratoconus. Whereas, corneal collagen cross-linking is a relatively new surgical procedure that may halt keratoconus progression by altering the pathophysiology of the disease with an application of riboflavin and ultraviolet A (UVA) radiation.
Riboflavin is a non-toxic, photosensitive element that easily penetrates the corneal stroma.(Spoerl, Huhle et al. 1998) When it is sensitized by UVA, interfibrillar bonds (cross-links) are formed between the collagen molecules, which stiffens the cornea.(Spoerl, Huhle et al. 1998) Different variants of riboflavin solution with regards to osmolarity (isotonic (standard) or hypotonic) and duration are used in cross-linking. However, there is a paucity of data on the comparative effectiveness of each type. This descriptive study aims to evaluate the short- and long-term effects and safety of different variants of Riboflavin for corneal cross-linking. This study will find the association of variation of riboflavin with the other clinical parameters such as corneal thickness in determining the outcomes of corneal cross-linking. From this study, we hope to make evidence-based recommendations on selection of appropriate variation of riboflavin for corneal cross-linking on different clinical situations.

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Corneal cross-linking, Descriptive study, keratoconus, Riboflavin, Save Sight Keratoconus Registry

Opportunity ID

The opportunity ID for this research opportunity is: 2670