title: Corneal collagen cross-linking in the stabilization of PRK, LASIK, thermal keratoplasty, and orthokeratology.
abstract: OBJECTIVE
  To describe the use of corneal collagen cross-linking (CXL) and its efficacy in the stabilization of keratorefractive procedures, including PRK, laser in-situ keratomileusis (LASIK), thermal keratoplasty, and orthokeratology.
  
  
  RESULTS
  Since its introduction, CXL has quickly gained interest in the treatment of ectactic disorders due to its ability to increase the biomechanical stability of the cornea. In its earliest use, it has shown to be effective in the treatment of both keratoconus and post-LASIK ectasia. More recent studies of CXL in combination with keratorefractive procedures have shown varying degrees of success.
  
  
  CONCLUSIONS
  CXL with PRK has shown to be effective in slowing or halting the progression of keratoconus, pellucid marginal degeneration, and post-LASIK ectasia, in addition to potentially decreasing or delaying the need for penetrating keratoplasty. Several small case series have also demonstrated improved stability and efficacy of PRK and LASIK when combined with CXL, as well as a potentially decreased risk of postprocedure ectasia. In conjunction with thermokeratoplasty and orthokeratology, CXL has shown improved but only temporary results in the treatment of keratoconus. Future studies are needed to determine the efficacy and long-term stability of CXL in combination with keratorefractive procedures, as well as to address possible complications.
authors.affiliation: Department of Ophthalmology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Michelle K
authors.initials: MK
authors.lastname: Nguyen
authors.forename: Roy S
authors.initials: RS
authors.lastname: Chuck
mesh_terms: D001696:Biomechanical Phenomena; D003094:Collagen / Q000378:metabolism*; D003131:Combined Modality Therapy; D003319:Corneal Stroma / Q000378:metabolism*; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D004108:Dilatation, Pathologic / Q000188:drug therapy; D004564:Electrocoagulation; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D054158:Orthokeratologic Procedures; D018903:Photorefractive Keratectomy; D017319:Photosensitizing Agents / Q000627:therapeutic use
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen