Corneal Cross-Linking, Second Edition

Farhad Hafezi, MD PhD ; J Bradley Randleman, MD

  • $139.95
  • ISBN 10 1-63091-210-7
  • ISBN 13 978-1-63091-210-9
  • 300 pp Hard Cover
  • Pub. Date: 2017
  • Order# 62109


Corneal Cross-Linking, Second Edition represents an innovative approach to treating primary acquired and secondary induced ectatic disorders. In addition, corneal cross-linking (CXL) has promising applications as an alternative in the treatment of corneal infectious and non-infectious melting, as well as conditions such as Fuchs’ endothelial dystrophy.



The new and expanded Second Edition of Corneal Cross-Linking by Drs. Farhad Hafezi and J. Bradley Randleman will provide a concise yet comprehensive summary of the CXL process, including the basic science foundations, treatment protocols and outcomes, recognition and management of potential complications, and modification of standard protocol for special circumstances.



Given all the changes in this rapidly progressing field, many brief topics from the first edition have now grown into full chapters or sections.  These include expanded sections on alternative treatment protocols, corneal imaging and biomechanics, combining cross-linking with other refractive treatments, and a section devoted specifically to the most highly debated controversies in the field today.



With each chapter being fully updated plus including over twenty new chapters that covers the latest advances and future directions, Corneal Cross-Linking, Second Edition represents the cutting-edge of CXL research and clinical practice.  



“Since the publication of the first edition of this book in 2013, our knowledge of corneal cross-linking has again significantly increased, both scientifically and clinically. Today, concise recommendations (guidelines for cross-linking) help the clinician to select the patients, make decisions, and provide optimal treatment”



-Eberhard Spoerl, PhD and Theo Seiler, MD, PhD





About the Editors

About the Associate Editor

Contributing Authors

Foreword by Eberhard Spoerl, PhD, and Theo Seiler, MD, PhD


Section I          Basic Principles of Corneal Biomechanics and Corneal Cross-Linking

Chapter 1            History of Corneal Cross-Linking

                             Eberhard Spoerl, PhD, and Frederik Raiskup, MD, PhD, FEBO

Chapter 2            Introduction to Corneal Biomechanics

                             William J. Dupps Jr, MD, PhD

Chapter 3            Fundamental Principles of Corneal Cross-Linking

                             Gregor Wollensak, MD

Chapter 4            Riboflavin, Ultraviolet Light, and the Photochemical Reaction

                             Arie L. Marcovich, MD, PhD, and Alexander Brandis, PhD

Chapter 5            The Role of Oxygen in Corneal Cross-Linking

                             Olivier Richoz, MD, PhD; Sabine Kling, PhD; and Farhad Hafezi, MD, PhD

Chapter 6            Cross-Linking Initiated by Other Chromophores and by Multiphoton Excitation

                             Irene Kochevar, PhD

Chapter 7            Corneal Cross-Linking Safety Considerations

                             Christina Giannikas Starcic, MD; Leejee H. Suh, MD; and Stephen L. Trokel, MD

Chapter 8            Molecular Aspects of Corneal Cross-Linking

                             Rohit Shetty, FRCS, PhD; Natasha Kishore Pahuja, DOMS; and Harsha Nagaraja, MS, FCE

Chapter 9            Evaluation and Diagnosis of Keratoconus and Pellucid Marginal Degeneration

                             Marcony R. Santhiago, MD, PhD; Yaron S. Rabinowitz, MD; and J. Bradley Randleman, MD

Chapter 10          Evaluation and Diagnosis of Postoperative Corneal Ectasia

                             J. Bradley Randleman, MD; Maria A. Woodward, MD, MS; and Marcony R. Santhiago, MD, PhD

Section II        Corneal Cross-Linking for Corneal Ectasias

Chapter 11          Corneal Cross-Linking for Progressive Keratoconus

                             Tobias Koller, MD; Stefan Seiler, MD; and Theo Seiler, MD, PhD

Chapter 12          Corneal Cross-Linking for Postoperative Corneal Ectasia

                             David Tabibian, MD, and Farhad Hafezi, MD, PhD

Chapter 13          Corneal Cross-Linking for Pellucid Marginal Degeneration

                             Leopoldo Spadea, MD, and Roberto Secondi, MD

Section III      Corneal Cross-Linking Protocols and Complication Management

Chapter 14          The Standard Protocol and Its Parameters

                             Maria A. Woodward, MD, MS; David L. DeMill, MD; Francis W. Price Jr, MD; and

                             Marianne O. Price, PhD, MBA

Chapter 15          Corneal Cross-Linking Using Accelerated Protocols

                             George D. Kymionis, MD, PhD; Konstantinos I. Tsoulnaras, MD; and
                             Chrysanthi Koutsandrea, MD, PhD

Chapter 16          Epithelium-On Protocols: Conceptual/Basic Science

                             Eberhard Spoerl, PhD, and Suphi Taneri, MD

Chapter 17          Transepithelial Corneal Cross-Linking in Progressive Keratoconus

                             Frederik Raiskup, MD, PhD, FEBO

Chapter 18          Corneal Cross-Linking With Iontophoresis

                             Paolo Vinciguerra, MD; Riccardo Vinciguerra, MD; Fabrizio Camesasca, MD; Vito Romano, MD;
                             and Pietro Rosetta, MD

Chapter 19          Cross-Linking Protocols in Thin Corneas

                             Soosan Jacob, MS, FRCS, DNB, and Amar Agarwal, MS, FRCS, FRCOphth

Chapter 20          Pediatric Corneal Cross-Linking

                             Joseph Frucht-Pery, MD, and Denise Wajnsztajn, MD

Chapter 21          Corneal Cross-Linking Complications and Management

                             Karolinne Maia Rocha, MD, PhD; Koray Gümüş, MD, FEBOphth; and J. Bradley Randleman, MD

Section IV      Corneal Cross-Linking Imaging and Diagnostic Evaluations

Chapter 22          Measuring the Efficacy of Corneal Cross-Linking Using Advanced Corneal
                             Biomechanical Diagnostic Modalities

                             Renato Ambrósio Jr, MD, PhD; Marcella Q. Salomão, MD; and Cynthia Roberts, PhD

Chapter 23          Measuring the Efficacy of Cross-Linking: Clinical Metrics

                             J. Bradley Randleman, MD, and Praneetha Thulasi, MD

Chapter 24          Measuring Corneal Cross-Linking Efficacy: Biomechanical Measurement Approach

                             Giuliano Scarcelli; Seok Hyun Yun; and J. Bradley Randleman, MD

Chapter 25          Confocal Microscopy in Corneal Cross-Linking

                             Cosimo Mazzotta, MD, PhD, and Luigi Fontana, MD, PhD

Chapter 26          Optical Coherence Tomography Use in Corneal Cross-Linking

                             Sumitra S. Khandelwal, MD, and J. Bradley Randleman, MD

Chapter 27          Epithelial Remodeling After Corneal Cross-Linking

                             Karolinne Maia Rocha, MD, PhD, and Sudeep Dilip Sunthankar, MD

Section V        Cross-Linking Plus: Combination Procedures

Chapter 28          Corneal Cross-Linking in Combination With Transepithelial Phototherapeutic Keratectomy:
                             Cretan Protocol

                             George D. Kymionis, MD, PhD; Michael A. Grentzelos, MD;
                             and Chrysanthi Koutsandrea, MD, PhD

Chapter 29          Corneal Cross-Linking in Combination With Surface Ablation: Athens Protocol

                             Anastasios John Kanellopoulos, MD, and George Asimellis, PhD

Chapter 30          Corneal Cross-Linking in Combination With Intracorneal Ring Segment

                             Aylin Kılıç, MD, and David Touboul, MD

Chapter 31          Corneal Cross-Linking in Combination With Phakic Intraocular Lenses

                             Jose L. Güell, MD, PhD; Merce Morral, MD, PhD; Emilio J. Segovia, MD; Oscar Gris, MD, PhD;
                             Daniel Elies, MD; and Felicidad Manero, MD

Chapter 32          Corneal Cross-Linking: Combined Treatment Options

                             Efekan Coskunseven, MD, and Onurcan Sahin, MSc

Chapter 33          Corneal Cross-Linking as a Primary Refractive Procedure

                             George D. Kymionis, MD, PhD; Dimitra M. Portaliou, MD, PhD, FEBO; Michael A. Grentzelos, MD;
                             and Chrysanthi Koutsandrea, MD, PhD

Section VI      Cross-Linking for Infectious Keratitis: PACK-CXL

Chapter 34          PACK-CXL

                             Jes Mortensen, MD, and Karim Makdoumi, MD, PhD

Chapter 35          PACK-CXL for Viral Keratitis and Acanthamoeba Keratitis

                             Francis W. Price Jr, MD, and Marianne O. Price, PhD, MBA 

Section VII    Other Uses for Cross-Linking

Chapter 36          Corneal Cross-Linking for Corneal Stromal Edema

                             Niels Ehlers, MD, PhD, and Jesper Hjortdal, MD, PhD

Chapter 37          Sclera Cross-Linking

                             Brendan Geraghty, BEng(Hons), MSc, PhD, and Ahmed Elsheikh, BEng(Hon), MSc, PhD

Section VIII   Current Controversies and Perspectives

Chapter 38          Epithelium-On Treatments

                             In Favor

                             Steven E. Wilson, MD, and Andre A.M. Torricelli, MD, PhD


                             Aldo Caporossi, MD, PhD, FRCS; Antonio Villano, MD; Stefano Baiocchi, MD, PhD;
                             and Orsola Caporossi, MD, PhD

Chapter 39          Corneal Cross-Linking Can Impact Limbal Stem Cells

                             In Favor

                             Johnny E. Moore, FRCOphth, PhD; David Schiroli, PhD; and C.B. Tara Moore, PhD


                             Farhad Hafezi, MD, PhD, and Sabine Kling, PhD

Chapter 40          Performing Corneal Cross-Linking After Definitive Signs of
                             Ectasia Progression Are Detected

                             Renato Ambrósio Jr, MD, PhD; Rosane de Oliveira Corrêa, MD;
                             and Rozalia Litewski Beildeck, MD

Chapter 41          Prophylactic Cross-Linking Combined With LASIK

                             In Favor

                             Anastasios John Kanellopoulos, MD, and George Asimellis, PhD


                             Theo Seiler, MD, PhD

Chapter 42          Summary of Commercially Available Corneal Cross-Linking Units

                             George O. Waring IV, MD, FACS; Susannah L. Brown, MD;
                             and Frederik Raiskup, MD, PhD, FEBO


Financial Disclosures


Malik Y. Kahook, MD is Professor of Ophthalmology and Director of Clinical and Translational Research in the Department of Ophthalmology at the University of Colorado. He also directs the glaucoma service and glaucoma fellowship. Dr. Kahook specializes in the medical and surgical treatment of glaucoma and cataracts. He is active within the ophthalmology community, including memberships in the American Academy of Ophthalmology, American Glaucoma Society, American Society of Refractive and Cataract Surgeons, and the Association for Research in Vision and Ophthalmology. Dr. Kahook has authored more than 200 peer-reviewed manuscripts, abstracts, and book chapters, and is editor of 4 textbooks, including Essentials of Glaucoma Surgery (SLACK Incorporated). He is on the editorial board of the American Journal of Ophthalmology and International Glaucoma Review, among others. He was awarded an American Glaucoma Society Clinician-Scientist Fellowship Award for 2007, as well as the American Glaucoma Society Compliance Grant for 2006, and was named New Inventor of the Year for the University of Colorado in 2009 and Inventor of the Year for 2010. Dr. Kahook received the American Academy of Ophthalmology Achievement Award in 2011. He has filed for more than 12 patents, several of which have been licensed by companies for development and commercialization. He currently serves as a consultant to the US Food and Drug Administration’s Ophthalmic Device Division. 
 Dr. Kahook completed his residency training at the University of Colorado, Rocky Mountain Lions Eye Institute in Denver, Colorado, where he was named Chief Resident. He then went on to complete his fellowship in glaucoma from the University of Pittsburgh Medical Center in Pittsburgh, Pennsylvania.

Joel S. Schuman, MD, FACS is the Eye and Ear Foundation Professor and Chairman of Ophthalmology, the Eye and Ear Institute, University of Pittsburgh School of Medicine and Director of the University of Pittsburgh Medical Center (UPMC) Eye Center. He is also Professor of Bioengineering at the Swanson School of Engineering, University of Pittsburgh, and a Founder of the Louis J. Fox Center for Vision Restoration of UPMC and the University of Pittsburgh. He is a member of the McGowan Institute for Regenerative Medicine and the Center for the Neural Basis of Cognition, Carnegie Mellon University and University of Pittsburgh. Dr. Schuman is a native of Roslyn, New York; he graduated from Columbia University (BA, 1980) and Mt. Sinai School of Medicine (MD, 1984). Following his internship at New York’s Beth Israel Medical Center (1985), he completed residency training at Medical College of Virginia (1988) and glaucoma fellowship at Massachusetts Eye & Ear Infirmary (clinical 1989; research 1990), where he was a Heed Fellow. After just over a year on the Harvard faculty, he moved to the New England Medical Center, Tufts University, to co-found the New England Eye Center in 1991, where he was Residency Director and Glaucoma and Cataract Service Chief. In 1998, he became Professor of Ophthalmology, and Vice Chair in 2001.

Dr. Schuman and his colleagues were the first to identify a molecular marker for human glaucoma, as published in Nature Medicine in 2001. He has been continuously funded by the National Eye Institute as a principal investigator since 1995, is principal investigator of a National Institutes of Health (NIH) grant to study novel glaucoma diagnostics, and is co-investigator of NIH grants for research into novel optical diagnostics and short pulse laser surgery and for advanced imaging in glaucoma. He is an inventor of optical coherence tomography (OCT), used world-wide for ocular diagnostics. Dr. Schuman has published more than 250 peer-reviewed scientific journal articles, has authored or edited 8 books, and has contributed more than 50 book chapters.

In 2002, Dr. Schuman received the Alcon Research Institute Award, as well as the New York Academy of Medicine’s Lewis Rudin Glaucoma Prize. In 2003, he received the Senior Achievement Award from the American Academy of Ophthalmology. In 2004, he was elected into the American Society for Clinical Investigation. In 2006, he received the Association for Research in Vision and Ophthalmology (ARVO) Translational Research Award. He was elected to the American Ophthalmological Society in 2008. He received a 2006-2009 American Medical Association Physician’s Recognition Award with Commendation. In 2010, he became a silver Fellow of ARVO. In 2011, Dr. Schuman was the Clinician-Scientist Lecturer of the American Glaucoma Society. In 2012, he received the Carnegie Science Center’s Award in Life Sciences and was a co-recipient of the Champalimaud Award.