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Related Experiment Video

Updated: Mar 24, 2026

Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
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Customized Corneal Cross-linking: One-Year Results.

Theo G Seiler1, Isaak Fischinger1, Tobias Koller2

  • 1Department of Ophthalmology, Inselspital, Universität Bern, Bern, Switzerland; Institut für Refraktive und Ophthalmo-Chirurgie (IROC), Zürich, Switzerland.

American Journal of Ophthalmology
|March 6, 2016
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Summary

Customized corneal cross-linking (CXL) offers improved outcomes for keratoconus patients, showing greater flattening and faster healing than standard CXL. This advanced treatment appears as safe as the conventional method.

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Vision Science

Background:

  • Keratoconus is a progressive corneal disease causing vision distortion.
  • Corneal cross-linking (CXL) is a standard treatment to halt keratoconus progression.
  • Optimizing CXL techniques may enhance treatment efficacy.

Purpose of the Study:

  • To compare the effectiveness of customized corneal cross-linking (CXL) against standard CXL in treating progressive primary keratoconus.
  • To evaluate visual acuity, corneal topography, and epithelial healing after both treatment modalities.

Main Methods:

  • A prospective, nonrandomized comparative study involving 40 eyes with progressive keratoconus.
  • Patients received either customized CXL (n=20) or standard CXL (n=20).
  • Evaluations included Scheimpflug tomography, endothelial cell count, BSCVA, and OCT, assessed preoperatively and 1 year postoperatively.

Main Results:

  • Customized CXL demonstrated significantly better epithelial healing time, ΔKmax, and regularization index (RI).
  • A greater proportion of eyes in the customized group (37%) achieved ≥2 diopters of flattening compared to the standard group (11%).
  • Statistically significant correlations between RI and preoperative parameters were observed exclusively in the customized CXL group.

Conclusions:

  • Customized CXL is as safe as standard CXL for keratoconus treatment.
  • Customized CXL leads to stronger flattening of Kmax and RI.
  • The customized approach offers a faster epithelial healing period compared to standard CXL.