title: Corneal collagen cross-linking in keratoconus: a systematic review and meta-analysis.
abstract: The aim of this study was to determine the effectiveness of corneal collagen cross-linking (CXL) for the treatment of progressive keratoconus (KC). Some of the published literature, including a few small, randomized controlled trials (RCTs), demonstrated good results after CXL, but large RCTs with long-term follow-up to establish a cause-effect relationship are lacking. Using PubMed, EMBASE, and the Cochrane Library database, we searched for relevant studies published between October 2007 and March 2014. A comprehensive literature search was performed using the Cochrane Collaboration methodology to identify the effectiveness of CXL for treating KC. The primary outcome parameters included uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), refraction, corneal topography, and corneal thickness at baseline and at 1, 3, 6, 12, and 18 months after CXL. A total of 1171 participants (1557 eyes) were enrolled in this meta-analysis. CXL may be effective in halting the progress of KC for at least 12 months under certain conditions. However, further research from randomized trials is needed to confirm our findings.
authors.affiliation: General Navy Hospital Eye Department, #6 Fucheng Road, Beijing, China, 100048.
authors.forename: Tian
authors.initials: T
authors.lastname: Chunyu
authors.affiliation: General Navy Hospital Eye Department, #6 Fucheng Road, Beijing, China, 100048.
authors.forename: Peng
authors.initials: P
authors.lastname: Xiujun
authors.affiliation: General Navy Hospital Eye Department, #6 Fucheng Road, Beijing, China, 100048.
authors.forename: Fan
authors.initials: F
authors.lastname: Zhengjun
authors.affiliation: General Navy Hospital Eye Department, #6 Fucheng Road, Beijing, China, 100048.
authors.forename: Zhang
authors.initials: Z
authors.lastname: Xia
authors.affiliation: PLA General Hospital Intensive Care Center, #28 Fuxing Road, Beijing, China, 100853.
authors.forename: Zhou
authors.initials: Z
authors.lastname: Feihu
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003094:Collagen / Q000627:therapeutic use*; D003315:Cornea / Q000187:drug effects*; D019781:Corneal Topography / Q000379:methods; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen