title: Corneal collagen crosslinking: a systematic review.
abstract: 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 corneal stiffness. In recent years, CXL has been an established treatment for the arrest of KCN, PLE and PMD progression. CXL has also been shown to be effective in the treatment of corneal infections, chemical burns, bullous keratopathy and other forms of corneal edema. This is a current review of CXL - its biomechanical principles, the evolution of CXL protocols in the past, present and future, indications for treatment, treatment efficacy and safety.
authors.affiliation: Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Nir
authors.initials: N
authors.lastname: Sorkin
authors.forename: David
authors.initials: D
authors.lastname: Varssano
mesh_terms: D003094:Collagen / Q000378:metabolism*; D003315:Cornea / Q000503:physiopathology; D003319:Corneal Stroma / Q000378:metabolism*; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D004548:Elasticity / Q000502:physiology; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D012256:Riboflavin / Q000627:therapeutic use; D014466:Ultraviolet Rays
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin