Expanding indications for corneal cross-linking

Author:

Hafezi Farhad12345,Torres-Netto Emilio A.126,Hillen Mark1

Affiliation:

1. ELZA Institute, Dietikon/Zurich

2. Laboratory of Ocular Cell Biology, Center for Applied Biotechnology and Molecular Medicine, University of Zurich, Zurich

3. Faculty of Medicine, University of Geneva, Geneva, Switzerland

4. USC Roski Eye Institute, University of Southern California, Los Angeles, California, USA

5. Department of Ophthalmology, Medical University of Wenzhou, Wenzhou, China

6. Department of Ophthalmology, Paulista School of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil

Abstract

Purpose of review The aim of this study was to summarize the recent developments in corneal cross-linking (CXL) and its indications, including corneal ectasias, refractive surgery and infectious keratitis. Recent findings Advances in CXL technology, such as the use of higher-intensity LED ultraviolet (UV) light sources and a better understanding of the UV-riboflavin photochemical reaction, have enabled safer and more effective methods of cross-linking thin and ultra-thin corneas, and more effective accelerated transepithelial/‘epi-on’ CXL procedures that are beginning to supplant the Dresden protocol as the ‘gold standard’ CXL method. CXL is also being used in combination with laser surgery, not only to expand the patient base who can receive refractive surgery, but also to help rehabilitate vision in patients with ectasia. CXL, and CXL combined with photorefractive keratectomy (PRK), can result in corneal flattening of 1–2 D, and corneal regularization of 4–5 D, respectively. Finally, photoactivated chromophore for keratitis-corneal cross-linking (PACK-CXL) has been shown to be an effective therapy for infectious keratitis, both alone, and in combination with antimicrobial drugs. Summary CXL has evolved from a single technique to treat a single corneal ectasia, keratoconus, to several techniques with several indications, spanning a spectrum of corneal ectasias, as well as visual rehabilitation, refractive procedures and infectious keratitis treatment.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Ophthalmology,General Medicine

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