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Updated: Jan 31, 2026

Nanosponge Tunability in Size and Crosslinking Density
Published on: August 4, 2017
Current concepts in crosslinking thin corneas
Rashmi Deshmukh1, Farhad Hafezi2, George D Kymionis3
1Cornea, Cataract and Refractive Services, Centre for Sight Hospital, New Delhi, India.
Abstract:
Corneal cross-linking (CXL), introduced by Wollensak et al. in 2003, is a minimally invasive procedure to halt the progression of keratoconus. Conventional CXL is recommended in eyes with corneal thickness of at least 400 microns after de-epithelialization to prevent endothelial toxicity. However, most of the keratoconic corneas requiring CXL may not fulfill this preoperative inclusion criterion. Moderate-to-advanced cases are often found to have a pachymetry less than this threshold. There are various modifications to the conventional method to circumvent this issue of CXL thin corneas while avoiding the possible complications. This review is an update on the modifications of conventional CXL for thin corneas.
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