title: Collagen cross-linking: when and how? A review of the state of the art of the technique and new perspectives.
abstract: Since the late 1990s corneal crosslinking (CXL) has been proposed as a new possibility to stop progression of keratoconus or secondary corneal ectasia, with the promising aim to prevent progressive visual loss due to the evolution of the pathology and to delay or avoid invasive surgical procedures such as corneal transplantation. The possibility of strengthening corneal tissue by means of a photochemical reaction of corneal collagen by the combined action of Riboflavin and ultraviolet A irradiation (UVA), radically modified the conservative management of progressive corneal ectasia. This is a review of the state of the art of CXL, reporting basic and clinical evidence. The paper describes basic principles, advantages and limits of different CXL techniques and possible future evolution of the procedure.
authors.affiliation: Ophthalmology Department, Policlinico SS Annunziata, Center of Excellence and National High-Tech Center (CNAT) in Ophthalmology, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini, 31 66100 Chieti, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Mastropasqua
keywords: Collagen corneal cross-linking epithelium off; Collagen corneal cross-linking epithelium on; Collagen cross-linking; Ectasia; Keratoconus; Transepithelial cross-linking; Transepithelial cross-linking with iontophoresis