The authors treat seven eyes with progressive keratoconus with a high energy (18mW) for five minutes delivering a total energy similar to that suggested by the original Dresden protocol (3mW for 30mins). All eyes had a thickness >400µm following epithelial removal and were treated with iso-osmotic riboflavin. Corrected distance visual acuity (CDVA), keratometry (Kmax and K mean) and endothelial cell density (ECD) were measured at each follow-up. No intra or postoperative complications were noted. At one and six months postoperatively, there was no significant change in Kmax, Kmean or ECD. The authors claim that the Bunson-Roscoe law of reciprocity can be applied effectively by increasing the power and shortening the duration of treatment, but acknowledge the small numbers and short duration of study.
High-fluence collagen cross-linking
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