World Eye and Vision Congress

Cornea collagen crosslinking has emerged as a highly successful treatment for keratoconus and post-LASIK ectasia. The use of topical concentrated ribofl avin solution, along with a calibrated ultraviolet light source has been shown to successfully cross-link and stiff en the cornea align storm and arrest and in most cases, reduce the eff ect of corn steepening in several degenerative cornea conditions including keratoconus and post-refractive surgery ectasia. Cornea cross-linking with the Avedro commercial UV light source and concentrated topical ribofl avin solution produced in a standard dose is widely accepted and was FDA approved in the USA in 2016 as a treatment for Keratoconus and post refractive surgery ectasia. Th e high fi nancial treatment cost, along with the high cost of the Avedro machine, has limited ophthalmologist’s and patient’s access to this new eff ective treatment. We report cases at three separate institutions where patients, either on the own or under the suggestion of their ophthalmologist ingested high doses of dietary ribofl avin (Vitamin B2) and were exposed to 15 minutes per day of direct sunlight and noted within 6 months to experience a signifi cant amount of cornea fl attening by both topographic and keratometric measurements. No adverse eff ects were observed or reported in patients taking up to 1500 mg of dietary ribofl avin per day and spending 15 minutes daily outdoors walking briskly facing the sun

without sunglasses. We conclude that high-dose dietary ribofl avin may have a place in the treatment of keratoconus and post-refractive surgery kerectasia as an economical alternative or adjunctive form of treatment. It may be especially useful in paediatric and pregnant patients who are more likely to regress aft er commercial cross-linking therapy.