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Related Experiment Video

Updated: Apr 13, 2026

Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
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[Corneal collagen crosslinking in keratoconus].

L Jouve1, V Borderie1, C Temstet1

  • 1Service d'ophtalmologie 5, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Université UPMC Paris VI, UMR S 968, Institut de la vision, 17, rue Moreau, 75012 Paris, France.

Journal Francais D'Ophtalmologie
|April 30, 2015
PubMed
Summary

Corneal collagen crosslinking (CXL) is the sole treatment to halt progressive keratoconus by strengthening the cornea with riboflavin and UVA light. New protocols and combinations with other surgeries may enhance outcomes and reduce complications.

Keywords:
CorneaCornéeCrosslinkingKeratoconusKératocône

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Area of Science:

  • Ophthalmology
  • Biomedical Engineering

Context:

  • Keratoconus is a progressive corneal disease leading to vision impairment.
  • Corneal collagen crosslinking (CXL) is the only established treatment to arrest keratoconus progression.

Purpose:

  • To review the current understanding and applications of corneal collagen crosslinking (CXL) for keratoconus.
  • To discuss the mechanism, indications, safety, and emerging applications of CXL.

Summary:

  • CXL utilizes riboflavin and ultraviolet A (UVA) to enhance corneal rigidity by forming covalent bonds between collagen fibrils.
  • The conventional CXL protocol is indicated for progressive keratoconus (corneal thickness ≥400 μm) and post-LASIK ectasia, especially in young patients.
  • While generally safe and effective, CXL can rarely cause infectious keratitis or stromal scars due to epithelial debridement. Novel protocols and combined surgical approaches are under investigation to improve outcomes and minimize complications.

Impact:

  • CXL effectively slows or stops keratoconus progression, preserving vision.
  • Emerging evidence suggests CXL may have future therapeutic roles in treating infectious keratitis and stromal edema due to its antimicrobial and anti-edematous properties.
  • Investigational CXL protocols and combination therapies aim to enhance visual outcomes and reduce complication rates in keratoconus management.