Corneal collagen cross-linking: an introduction and literature review

This literature review analyzes the scientific evidence available regarding corneal collagen cross-linking (CXL) as a treatment option for progressive keratectasia.

A literature search was performed using dates from 1990 to August 2010 regarding CXL Specific areas of focus for the literature review include safety and efficacy of the procedure as a stand-alone treatment or when used in conjunction with Intacs® corneal implants (Addition Technology™) or photorefractive keratectomy (PRK).

A total of 50 clinical trials and studies were identified, 20 of which met the inclusion criteria. Results of the included literature support the conclusion that CXL is a safe and efficacious treatment for progressive keratectasia. The results of CXL alone have shown stabilization or improvement in the maximum keratometry readings, best-corrected visual acuity, uncorrected visual acuity, and spherical and cylinder refractive measurements. CXL has been shown to enhance the effects of Intacs and has been proven successful when used in conjunction with PRK.

CXL is an effective treatment for limiting the progression of keratectasia, thus reducing the need for penetrating keratoplasty. CXL has a similar side-effect profile and similar risk level as PRK.