Corneal collagen cross-linking for nonectatic disorders: a systematic review

Area of Science:

• Ophthalmology
• Biochemistry
• Biomaterials Science

Background:

• Corneal collagen cross-linking (CXL) utilizes riboflavin and ultraviolet A light to enhance corneal biomechanical strength.
• Established for treating corneal ectasia, CXL's potential in other corneal conditions is under investigation.

Purpose of the Study:

• To review the biochemical basis of CXL.
• To evaluate CXL's efficacy and safety in non-ectatic corneal disorders.
• To explore novel applications and identify research gaps for CXL.

Main Methods:

• Comprehensive literature search of EMBASE and MEDLINE databases (1970-November 2011).
• Keywords included various combinations of "corneal collagen cross linking," "ultraviolet," "riboflavin," "corneal edema," and "keratitis."
• Reference lists of retrieved articles were also reviewed.

Main Results:

• CXL demonstrated temporary improvements in corneal thickness, visual acuity, and clarity for corneal edema.
• Adjunctive CXL for infectious keratitis was well-tolerated, halting corneal melting and preventing keratoplasty.
• Studies indicated a temporary benefit in objective and subjective measures for corneal edema.

Conclusions:

• CXL is a promising minimally invasive treatment for corneal ectasia.
• Emerging evidence suggests benefits for corneal edema and infectious keratitis.
• Long-term outcomes and safety require further investigation.