Dr Sally Hayes and Dr Siân MorganAMJAD NAIF ALMUTAIRI2022-06-042022-01-252022-06-04109872https://drepo.sdl.edu.sa/handle/20.500.14154/65923corneal thickness and enzymatic resistance have shown successful results in keratoconus management with the assistance of riboflavin–UVA CXL, thereby reducing progression. Outcomes of pre-UVA rinse cross-linked treatment protocols handled with high intensity measures on corneal enzymatic resistance is yet to be further investigated. Both Ribo only and CXL with pre-UVA BSS rinse 10ml/20sec protocols resulted in negligible corneal enzymatic resistance. CXL with pre-UVA BSS rinse (1ml/2sec) and riboflavin replenishment protocol than the other treatment groups showed significant differences in enzymatic resistance towards digestion.91enThesis