Epithelial Complications in Various Corneal Collagen Crosslinking Protocols

Abstract

This literature review describes epithelial complications that occur after corneal collagen crosslinking. Currently, the standard, different variants of the transepithelial and accelerated protocols, as well as their combination, are used. Moreover, in most cases, there are problems and complications associated with de-epithelialization or with impact to the preserved epithelium, both with special substances that destroy tight connections between epithelial cells, and with UV radiation, which supplied with increased illumination intensity and in a shorter time. At the same time, the development of many new options for various modifications and protocols for the corneal collagen crosslinking in order to preserve the epithelium and, thereby, provide the comfort and safety for the patient, can lead to a vicious circle in the form of epithelial complications and a decrease in the effect of the procedure. Therefore, it is important to conduct more complete, standardized studies aimed at a comprehensive assessment of all aspects and parameters of the corneal crosslinking procedure.