Corneal Collagen Crosslinking: A Systematic Review

@article{Sorkin2014CornealCC,
  title={Corneal Collagen Crosslinking: A Systematic Review},
  author={Nir Sorkin and David Varssano},
  journal={Ophthalmologica},
  year={2014},
  volume={232},
  pages={10 - 27}
}
Keratoconus (KCN) is an ectatic disorder with progressive corneal thinning and a clinical picture of corneal protrusion, progressive irregular astigmatism, corneal fibrosis and visual deterioration. Other ectatic corneal disorders include: post-LASIK ectasia (PLE) and pellucid marginal degeneration (PMD). Corneal crosslinking (CXL) is a procedure whereby riboflavin sensitization with ultraviolet A radiation induces stromal crosslinks. This alters corneal biomechanics, causing an increase in… 

Tables from this paper

[Morphologic Corneal Changes after Crosslinking for Keratoconus].
TLDR
An overview about physiologic and pathologic changes in keratoconic corneas before and after crosslinking is given.
Microbial keratitis complicated by acute hydrops following corneal collagen cross‐linking for keratoconus
TLDR
The aim of this report is to describe what is believed to be the first case of microbial keratitis complicated by acute corneal hydrops in a patient with keratoconus following CXL, and to highlight the unique clinical course of Corneal Hydrops in such a case.
Current perspectives on corneal collagen crosslinking (CXL)
TLDR
It is evident from this review that in general, these modified techniques have succeeded in minimizing the immediate complications of the C-CXL technique, however, there were contradictory viewpoints regarding their effectiveness when compared with the conventional technique.
Complications of Corneal Collagen Cross-Linking
TLDR
All the modifications to the CXL standard protocol aim to minimize its side effects maintaining an adequate therapeutic effect and extending the indication of the treatment.
Role of corneal collagen fibrils in corneal disorders and related pathological conditions.
TLDR
The composition and distribution of corneal collagens as well as their degradation and contraction are discussed, the current status of corNEal tissue engineering and the progress of Corneal cross-linking are addressed, and the future of engineered corneas is addressed.
Management of Keratoconus: Recent Trends
TLDR
Recently, use of Intrastromal Corneal Ring Segments, Phakic IOLs, application of excimer laser and use of combination techniques have all made significant contribution in providing options for effective management of different stages of this disease.
Evaluation of Corneal Biomechanical Changes After Collagen Crosslinking in Patients with Progressive Keratoconus by Ocular Response Analyzer
TLDR
CXL is a treatment modality believed to affect corneal biomechanics in keratoconus, but the results of larger patient series with longer follow-up periods may enable a better evaluation.
Outcomes of corneal collagen cross linking prior to photorefractive keratectomy in prekeratoconus
TLDR
The mechanism of CXL is believed when riboflavin as a photosensitizer is saturated on the cornea while exposed to ultraviolet irradiation, thus it is excited into an activate state that generating some reactive oxygen species leads to the formation of covalent bond between collagen molecules that increase the corneal biomechanics.
Patient selection for corneal collagen cross-linking: an updated review
TLDR
The current knowledge on patient selection for CXL, its indications, and options in special cases (such as thin corneas) are reviewed.
Corneal Cross-Linking (with a Partial Deepithelization) in Keratoconus with Five Years of Follow-Up
TLDR
It is suggested that this modified corneal CXL technique is a safe and effective alternative to halt the progression of KC up to five years after the procedure, however, some concerns remain as to whether this technique can affect in some degree the cornea endothelial cells.
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