title: Combined laser in-situ keratomileusis and accelerated corneal cross-linking: an update.
abstract: OBJECTIVE
  The purpose is to review the literature of combined laser in-situ keratomileusis (LASIK) and accelerated corneal collagen cross-linking (CXL) in context of its indications-contraindications, kerato-refractive, visual and safety outcomes, particularly with reference to preventing the development of post-LASIK ectasia.
  
  
  RESULTS
  LASIK + accelerated CXL has been developed with the rationale that the addition of CXL after LASIK may strengthen the LASIK compromised corneal biomechanics and minimize the complications such as post-LASIK ectasia. Different clinical studies have documented the safety and efficacy of LASIK + accelerated CXL for the correction of myopia or hyperopia and in the patients with low predicted residual bed thickness.
  
  
  CONCLUSIONS
  Available literature shows that refractive and keratometric outcomes of LASIK + accelerated CXL are comparable or better than LASIK alone. Less regression has been observed after LASIK + accelerated CXL compared with LASIK alone and no case of post-LASIK ectasia development has been reported among 673 eyes with the follow-up ranging from 3 months to 4.5 years. Future studies with large numbers of patients and longer postoperative follow-ups are needed to establish the efficacy of LASIK + accelerated CXL in preventing the development of post-LASIK ectasia.
authors.affiliation: Minoru Tomita Eye Clinic, Ginza, Tokyo, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Tomita
mesh_terms: D003094:Collagen / Q000378:metabolism; D003131:Combined Modality Therapy; D003315:Cornea / Q000601:surgery*; D003316:Corneal Diseases / Q000209:etiology / Q000517:prevention & control; D003319:Corneal Stroma / Q000378:metabolism; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D004108:Dilatation, Pathologic / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects / Q000379:methods*; D009216:Myopia / Q000628:therapy; D010778:Photochemotherapy / Q000009:adverse effects / Q000379:methods; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011183:Postoperative Complications; D054140:Refractive Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D012256:Riboflavin / Q000627:therapeutic use; D014792:Visual Acuity / Q000502:physiology
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin