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Hypotonic riboflavin refers to a formulation of riboflavin (vitamin B2) in a low-osmolarity (hypotonic) solution, primarily used as an ophthalmic agent in corneal collagen cross-linking procedures. This formulation is designed to swell the cornea and increase its thickness, which is particularly important for patients with thin corneas undergoing cross-linking for conditions such as progressive keratoconus or corneal ectasia following refractive surgery. The mechanism of action involves riboflavin acting as a photosensitizer; upon activation by ultraviolet A (UVA) light, it facilitates the formation of covalent bonds between collagen fibers in the corneal stroma, thereby strengthening and stabilizing the cornea[7][8][9]. Hypotonic solutions are specifically used when additional swelling of the cornea is required to reach safe treatment thresholds.
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