title: Accelerated corneal collagen crosslinking: Technique, efficacy, safety, and applications.
abstract: Corneal collagen crosslinking (CXL) is an approach used to increase the biomechanical stability of the stromal tissue. Over the past 10 years, it has been used to halt the progression of ectatic diseases. According to the photochemical law of reciprocity, the same photochemical effect is achieved with reduced illumination time and correspondingly increased irradiation intensity. Several new CXL devices offer high ultraviolet-A irradiation intensity with different time settings. The main purpose of this review was to discuss the current use of different protocols of accelerated CXL and compare the efficacy and safety of accelerated CXL with the efficacy and safety of the established conventional method. Accelerated CXL proved to be safe and effective in halting progression of corneal ectasia. Corneal shape responses varied considerably, as did the demarcation line at different irradiance settings; the shorter the exposure time, the more superficial the demarcation line.
  
  
  
  Dr. Santhiago is a consultant to Ziemer Ophthalmic Systems AG and Alcon Laboratories, Inc. None of the authors has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Department of Ophthalmology (Medeiros, Giacomin, Santhiago), University of São Paulo, São Paulo, the Sadalla Amin Ghanem Eye Hospital (Bueno, Ghanem), Joinville, and the Department of Ophthalmology (Moraes, Santhiago), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Carla S
authors.initials: CS
authors.lastname: Medeiros
authors.affiliation: From the Department of Ophthalmology (Medeiros, Giacomin, Santhiago), University of São Paulo, São Paulo, the Sadalla Amin Ghanem Eye Hospital (Bueno, Ghanem), Joinville, and the Department of Ophthalmology (Moraes, Santhiago), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Natalia T
authors.initials: NT
authors.lastname: Giacomin
authors.affiliation: From the Department of Ophthalmology (Medeiros, Giacomin, Santhiago), University of São Paulo, São Paulo, the Sadalla Amin Ghanem Eye Hospital (Bueno, Ghanem), Joinville, and the Department of Ophthalmology (Moraes, Santhiago), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Renata L
authors.initials: RL
authors.lastname: Bueno
authors.affiliation: From the Department of Ophthalmology (Medeiros, Giacomin, Santhiago), University of São Paulo, São Paulo, the Sadalla Amin Ghanem Eye Hospital (Bueno, Ghanem), Joinville, and the Department of Ophthalmology (Moraes, Santhiago), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Ramon C
authors.initials: RC
authors.lastname: Ghanem
authors.affiliation: From the Department of Ophthalmology (Medeiros, Giacomin, Santhiago), University of São Paulo, São Paulo, the Sadalla Amin Ghanem Eye Hospital (Bueno, Ghanem), Joinville, and the Department of Ophthalmology (Moraes, Santhiago), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Haroldo V
authors.initials: HV
authors.lastname: Moraes
authors.affiliation: From the Department of Ophthalmology (Medeiros, Giacomin, Santhiago), University of São Paulo, São Paulo, the Sadalla Amin Ghanem Eye Hospital (Bueno, Ghanem), Joinville, and the Department of Ophthalmology (Moraes, Santhiago), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: marconysanthiago@hotmail.com.
authors.forename: Marcony R
authors.initials: MR
authors.lastname: Santhiago
mesh_terms: D003094:Collagen / Q000737:chemistry*; D003319:Corneal Stroma; D003432:Cross-Linking Reagents; D006801:Humans; D007640:Keratoconus / Q000628:therapy; D012256:Riboflavin; D014466:Ultraviolet Rays
chemical_list: D003432:Cross-Linking Reagents; D003094:Collagen; D012256:Riboflavin