title: Cross-linking and intracorneal ring segments--review of the literature.
abstract: OBJECTIVE
  To review and summarize relevant studies on combined use of corneal crosslinking and intracorneal ring segments (ICRS) for the treatment of corneal ectasia.
  
  
  METHODS
  A literature search was performed using the key words "corneal collagen cross-linking" and "intra-corneal ring segments."
  
  
  RESULTS
  Crosslinking is a well-accepted treatment option for corneal ectasia and can be combined with corneal ICRS insertion as needed. The advent of crosslinking has dramatically reduced the number of corneal transplants performed for patients with keratoconus or postrefractive ectasia. Intracorneal ring segments, although flatten the corneal surface, do not prevent the progression of corneal ectasia. This is why the combination of crosslinking and ICRS is potentially synergistic. Previous studies reported that combining these two complementary interventions has been shown to be safe and effective.
  
  
  CONCLUSIONS
  The effects of ICRS are enhanced and stabilized by crosslinking, but the ideal combined technique is not known at present.
authors.affiliation: Department of Ophthalmology and Vision Sciences (N.A.-Z., D.S.R.), University of Toronto, Toronto, ON, Canada; and TLC (N.A.-Z., D.S.R.), Yonge Eglinton Laser Eye Center, Toronto, ON, Canada.
authors.forename: Noa
authors.initials: N
authors.lastname: Avni-Zauberman
authors.forename: David S
authors.initials: DS
authors.lastname: Rootman
mesh_terms: D003094:Collagen / Q000378:metabolism; D003131:Combined Modality Therapy; D003316:Corneal Diseases / Q000628:therapy*; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D004108:Dilatation, Pathologic / Q000628:therapy; D018450:Disease Progression; D006801:Humans; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012256:Riboflavin / Q000627:therapeutic use; D014466:Ultraviolet Rays
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin