A Comparison Between Cross-Linking Protocols in Patients With Progressive Keratoconus: A Review

Keratoconus (KC) is a noninflammatory cornea disease leading to progressive thinning, causing it to change from its normal dome shape to a cone shape. One of the novel treatments of KC is corneal collagen cross-linking (CXL). Due to its importance, many studies have been conducted to compare corneal cross-linking protocols; this review article aims to discuss corneal cross-linking and compare its different treatment options, including Dresden, accelerated, and customized protocols in patients with progressive KC and their respective long-term outcomes. A search was performed in PubMed and Google Scholar with no language, dates, or study type restriction. Most of the results showed almost no difference between protocols over traditional cross-linking. However, published data are limited, long-term outcomes of novel age groups remain unclear, and further studies are needed.