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Updated: May 22, 2026
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Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
Published on: November 12, 2015
Corneal collagen cross-linking: ectasia and beyond
Kunal Suri1, Kristin M Hammersmith, Parveen K Nagra
1Wills Eye Hospital, Jefferson Medical College of Thomas Jefferson University, 840 Walnut St., Philadelphia, PA 19107, USA.
Current Opinion in Ophthalmology
|May 10, 2012
Summary
Corneal collagen cross-linking effectively stabilizes ectasia, with regression noted in keratoconus and postrefractive surgery cases. Research explores new applications and safety modifications for this evolving therapeutic approach.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Biomaterials Science
Background:
- Corneal ectasia, including keratoconus and postrefractive surgery ectasia, presents a significant challenge in ophthalmic management.
- Corneal collagen cross-linking (CXL) has emerged as a promising therapeutic modality for managing these conditions.
Purpose of the Study:
- To review the recent literature (past 3 years) on corneal collagen cross-linking.
- To explore the expanding therapeutic applications and documented complications of CXL.
Main Methods:
- Systematic review of peer-reviewed literature published within the last three years.
- Analysis of studies investigating CXL for various corneal conditions and its modifications.
Main Results:
- CXL demonstrates efficacy in stabilizing corneal ectasia, with notable regression in keratoconus and postrefractive surgery cases.
- Investigated applications include combined procedures with intrastromal corneal ring segments and photorefractive keratectomy, as well as treatments for corneal edema and infectious keratitis.
- Modifications such as hypoosmolar riboflavin, transepithelial CXL, and varied UV-A exposure aim to enhance safety and efficacy.
- Complications reported include keratitis, corneal haze, endothelial cell loss, and treatment failure.
Conclusions:
- Corneal collagen cross-linking is an effective treatment for corneal ectasia, showing better regression in keratoconus than postrefractive ectasia.
- Emerging evidence suggests potential benefits for bullous keratopathy and infectious keratitis, warranting further investigation.
- While CXL with epithelial debridement appears most effective, ongoing research focuses on optimizing techniques for improved outcomes and safety profiles.
