Corneal collagen cross-linking outcomes: review

Area of Science:

• Ophthalmology
• Biomedical Engineering
• Corneal Science

Background:

• Keratoconus is a progressive, asymmetric, bilateral corneal disease.
• Characterized by biomechanical instability of the cornea.
• Current treatments aim to manage symptoms and slow progression.

Purpose of the Study:

• To evaluate the efficacy of corneal collagen cross-linking (CXL) for treating keratoconus and iatrogenic keratectasia.
• To assess the impact of CXL on corneal biomechanics, visual acuity, and refractive outcomes.
• To determine the long-term safety and effectiveness of CXL.

Main Methods:

• Corneal collagen cross-linking (CXL) using riboflavin and UVA irradiation.
• Assessment of corneal biomechanical properties and topographical changes.
• Measurement of visual acuity, refractive error, and endothelial cell density.

Main Results:

• CXL effectively halted keratoconus progression for up to four years.
• Significant reductions observed in maximum keratometry (K) readings (>2 D), spherical equivalent (SEQ) (>1 D), and refractive cylinder (~1 D).
• No loss of best corrected distance visual acuity (BCDVA), no significant decrease in endothelial cell density, and reduction in corneal aberrations.

Conclusions:

• CXL is a safe and effective treatment for stabilizing and potentially reversing corneal ectasia.
• CXL increases corneal biomechanical stability, offering a potential alternative to keratoplasty.
• Early consideration of CXL as a primary intervention is recommended to preserve corneal integrity.