Corneal crosslinking: Current protocols and clinical approach.

Kenneth A Beckman, Preeya K Gupta, Marjan Farid, John P Berdahl, Elizabeth Yeu, Brandon Ayres, Clara C Chan, José A P Gomes, Edward J Holland, Terry Kim, Christopher E Starr, Francis S Mah

Journal: Journal of cataract and refractive surgery 2020;45(11):1670-1679

PMID: 31706520

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Abstract

Members of the ASCRS Cornea Clinical Committee performed a review of the current literature on the corneal crosslinking (CXL) procedure for treating corneal ectasia. The members explored the data on the techniques currently in use and under investigation, including their advantages, safety profiles, risks, and cost analyses, compared with data on corneal transplantation. They concluded that CXL limits the progression of keratoconus, thus reducing the need for transplantation. They also found that compared with permitting the disease to progress naturally, CXL techniques carry significant and long-term cost and safety benefits, primarily by reducing the need for corneal transplantation. Studies of various CXL techniques (eg, epithelium-on treatment, changes in ultraviolet light parameters, riboflavin composition) continue with the ultimate goal of improving the procedure's safety and efficacy.

Address: Comprehensive Eyecare of Central Ohio, Westerville; Department of Ophthalmology, Ohio State University, Columbus. Electronic address: [email protected].; Duke Eye Center, Durham, North Carolina.; Gavin Herbert Eye Institute, University of California, Irvine.; Vance Thompson Vision, Sioux Falls, South Dakota.; Eastern Virginia Medical School, Norfolk; Virginia Eye Consultants, Norfolk.; Wills Eye Hospital, Philadelphia, Pennsylvania.; Department of Ophthalmology, University of Toronto, Ontario, Canada; Eye Bank of Canada, Ontario Division, Ontario, Canada.; Department of Ophthalmology, UNIFESP/EPM, São Paulo, Brazil; Instituto Suel Abujamra, São Paulo, Brazil.; Department of Ophthalmology, University of Cincinnati, Ohio; Cincinnati Eye Institute, Ohio.; Duke Eye Center, Durham, North Carolina; Duke University School of Medicine, Durham, North Carolina.; Weill Cornell Medicine, New York City; New York Presbyterian Hospital, New York City.; Scripps Clinic Medical Group, La Jolla, California; Department of Ophthalmology, University of Pittsburgh, USA.

DOI: 10.1016/j.jcrs.2019.06.027

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MeSH Terms: Collagen, Corneal Stroma, Cross-Linking Reagents, Humans, Keratoconus, Photochemotherapy, Photosensitizing Agents, Riboflavin, Ultraviolet Rays