Corneal Collagen Crosslinking for Ectasia After Refractive Surgery: A Systematic Review and Meta-Analysis

Area of Science:

• Ophthalmology
• Corneal Surgery
• Vision Science

Background:

• Corneal ectasia is a progressive condition causing irregular corneal curvature and vision loss.
• Refractive laser surgery (RLS) can sometimes lead to corneal ectasia.
• Effective management strategies are crucial for preserving visual function.

Purpose of the Study:

• To evaluate the safety and efficacy of corneal collagen cross-linking (CXL) for treating corneal ectasia post-RLS.
• To synthesize evidence from existing studies through a systematic review and meta-analysis.

Main Methods:

• Systematic review and meta-analysis adhering to PRISMA guidelines.
• Searched major databases (PubMed, EMBASE, Cochrane, Web of Science) for relevant studies.
• Analyzed outcomes including visual acuity, refractive error, topographic parameters, corneal thickness, and adverse events.

Main Results:

• Included 15 studies with 421 patients (512 eyes).
• Corneal collagen cross-linking (CXL) showed a significant improvement in corrected distance visual acuity and a decrease in maximum keratometry (Kmax).
• Central corneal thickness decreased significantly, while other topographic parameters and endothelial cell count remained stable; complications were infrequent.

Conclusions:

• Corneal collagen cross-linking (CXL) is a safe and effective therapeutic option for patients with corneal ectasia following refractive laser surgery (RLS).
• CXL offers a valuable approach to stabilize and potentially improve vision in this patient group.