Safety and efficacy of collagen crosslinking for the treatment of keratoconus.
BACKGROUND
Keratoconus is a condition that causes corneal ectasia and reduced vision in young adults. A proportion of these patients have progressive disease requiring corneal transplantation. A revolutionary new treatment that is purported to halt progression of keratoconus, known as collagen crosslinking (CXL), has recently been introduced into clinical practice.


METHODS
CXL involves the treatment of the cornea with riboflavin followed by photoactivation with UVA light leading to corneal strengthening. This article reviews the basic science, clinical protocols, safety aspects and clinical results of CXL.


RESULTS
The reader will gain a comprehensive understanding of: i) the basic science of CXL; ii) the optimised protocols for clinical use of CXL; iii) the results of all the main clinical trials in the literature; iv) contraindications to treatment and v) full clinical safety profile of CXL.


CONCLUSIONS
CXL represents a new treatment that uniquely allows the halt of progression of keratoconus, thus preventing visual loss and the need for surgical intervention. Available data suggest that this treatment has high efficacy and is very safe and may represent the future standard treatment for progressive keratoconus.
Kolli
Sai
S
Emmetropia Mediterranean Eye Clinic, Parodos Anopoleos 7, Heraklion, Crete, GR 71201, Greece. saikolli@me.com
Aslanides
Ioannis M
IM
D002985:Clinical Protocols; D002986:Clinical Trials as Topic; D003094:Collagen / Q000378:metabolism*; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy*; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012256:Riboflavin / Q000009:adverse effects / Q000627:therapeutic use*; D012449:Safety; D016896:Treatment Outcome; D014466:Ultraviolet Rays
D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin