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. 

Impact of fluorescein on the antimicrobial efficacy of photoactivated riboflavin in corneal collagen cross-linking.
Richoz O, Gatzioufas Z, Francois P, et al.
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Amit Patel

Heart of England NHS Foundation Trust, Birmingham, UK

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