title: Combined application of prophylactic corneal cross-linking and laser in-situ keratomileusis - a review of literature.
abstract: Laser in-situ keratomileusis (LASIK) is safe and effective laser refractive procedures in treating refractive errors. However, regression of treatment and iatrogenic keratectasia remain to be a major concern, especially in treating thin cornea with high ametropia. Collagen cross-linking (CXL) is an effective method in stopping keratoconus progression through increasing the biomechanical strength of the cornea. Adjuvant cross-linking to refractive procedures can theoretically help prevent regression and reduce the risk of keratectasia development by increasing the mechanical stability of cornea. During the procedure, riboflavin is directly applied to the corneal stroma, thereby reducing the need of de-epithelialization as in the conventional protocol for keratoconus. Currently, there is still no consensus regarding the indication of CXL during refractive procedure, nor any standardized treatment protocol. This article aims to summarize the current evidence regarding the use of adjuvant CXL in LASIK.
authors.affiliation: Hong Kong Eye Hospital, Kowloon, Hong Kong.|Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong.
authors.forename: Tommy C Y
authors.initials: TCY
authors.lastname: Chan
authors.affiliation: Department of Ophthalmology, The University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Alex L K
authors.identifier: http://orcid.org/0000-0002-8321-5634
authors.initials: ALK
authors.lastname: Ng
authors.affiliation: Department of Ophthalmology, Prince of Wales Hospital, New Territories, Hong Kong.
authors.forename: Karen K W
authors.initials: KKW
authors.lastname: Chan
authors.affiliation: Hong Kong Laser Eye Center, Kowloon, Hong Kong.
authors.forename: George P M
authors.initials: GPM
authors.lastname: Cheng
authors.affiliation: Department of Ophthalmology, The University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Ian Y H
authors.initials: IYH
authors.lastname: Wong
authors.affiliation: Hong Kong Eye Hospital, Kowloon, Hong Kong.|Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong.
authors.forename: Vishal
authors.initials: V
authors.lastname: Jhanji
mesh_terms: D003094:Collagen / Q000627:therapeutic use*; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D006801:Humans; D007640:Keratoconus / Q000150:complications* / Q000601:surgery; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents; D012030:Refractive Errors / Q000209:etiology / Q000517:prevention & control*; D014466:Ultraviolet Rays
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen
keywords: 
  LASIK
  ; collagen cross-linking; laser in-situ keratomileusis; refractive surgery