الفهرس 
Aim of workOnly 14 pages are availabe for public view
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Abstract
In conclusion, our results demonstrated that changes in human corneal endothelium may occur following UVA/riboflavin CXL. Although resolution of these changes during the follow-up may indicate a safe recovery, future consequences are not well known and have not become evident yet. It is always a concern that both photochemically induced free radicals and UVA irradiation itself have the potential to damage the intraocular structures including endothelium. Evaluation of the endothelial cell safety with regards to CXL is essential as it is gradually becoming the standard treatment option for progressive KC worldwide. We strongly recommend that the treatment guidelines for CXL including irradiance level and soaking time should be clearly established to minimize the toxic effects of the treatment. Therefore, corneal specialists need to be aware of the risks of CXL treatment and should document the endothelial parameters of the patients before and after the CXL treatment both for medical and legal issues. There are some limitations that need to be mentioned regarding this study: First, the peripheral corneal endothelium could not be evaluated which may be essential in determining the extent of endothelial cell damage and the contribution of peripheral cell migration in the recovery of normal central endothelial cell appearance. Second, a larger sample size and longer follow-up could have strengthened our conclusion and provided further insight into the potential long-term consequences of our findings. Also, using anterior segment OCT and confocal microscopy would have been more beneficial in demonstrating the depth of the treatment zone and the endothelium. CCT was measured by specular microscopy which is inaccurate compared to pachymetry. Lastly, mild corneal edema and ongoing healing process in the corneal epithelium may interfere with the specular microscopic measurements particularly at the first postoperative week. Nevertheless, we presented a similar trend in the all endothelial parameters at the first postoperative month also.