TY - BOOK AU - Rubinfeld, Roy S TI - Transepithelial crosslinking retreatment of progressive corneal ectasia unresponsive to classic crosslinking SN - 0886-3350 PY - 2017/// KW - *Corneal Diseases KW - *Keratomileusis, Laser In Situ KW - Adult KW - Collagen KW - Cornea KW - Corneal Diseases/th [Therapy] KW - Dilatation, Pathologic KW - Humans KW - Keratomileusis, Laser In Situ/mt [Methods] KW - Male KW - Retreatment KW - Riboflavin/ad [Administration & Dosage] KW - Visual Acuity KW - MedStar Washington Hospital Center KW - Ophthalmology KW - Journal Article N1 - Available online through MWHC library: 1999 - 2010, Available in print through MWHC library:1999-2007 N2 - A 41-year-old man presented 10 years after uneventful laser in situ keratomileusis (LASIK) with symptomatic post-LASIK ectasia. He had treatment with the classic Dresden epithelium-off technique and presented 4 years later with progression of the ectasia. He was subsequently retreated with conductive keratoplasty (CK) followed by a new proprietary epithelium-on corneal collagen crosslinking (CXL) procedure using a proprietary transepithelial riboflavin formulation and delivery system on the following day. One year after retreatment, the patient noted stable vision in the treated eye with a corrected distance visual acuity (CDVA) of 20/60+. Thus, epithelium-on CXL, if performed with appropriate formulations and delivery technology as well as careful attention to appropriate riboflavin loading of the stroma, can stabilize an ectatic cornea. In addition, when performed prior to CXL, CK can induce a significant, lasting improvement in corneal shape and CDVA. This technique merits further study; Copyright (c) 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved UR - https://dx.doi.org/10.1016/j.jcrs.2016.11.038 ER -