March 20, 2014
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Cross-linking: A milestone in the management of keratoconus

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The following is an excerpt from the commentary section of the March 2014 issue of Ocular Surgery News Europe Edition.

First developed by Theo Seiler and his team in Zurich in 1993, corneal collagen cross-linking, or CXL, was progressively adopted as a technique in the first decade of this century by several corneal specialists in Europe, gaining wide popularity over a relatively short period of time.

CXL represents, to date, the only effective way to slow down or stop the progression of keratoconus by strengthening the collagen fibers in the cornea. As shown by several studies, it is a relatively harmless procedure with a high rate of efficacy. Stabilization of the disease is obtained in approximately 90% of cases, and a mean decrease of 2 D in maximum keratometry is achieved, with a mean gain of two lines of vision in a number of eyes.

CXL indications have gradually broadened, maintaining the notion of progressive keratoconus as one of the basic criteria. Progression can be functional and/or physical, as objectively shown by topography, pachymetry or corneal aberrometry. CXL plays a critical role in the management of progressive keratoconus because it is the only treatment capable of stabilizing the disease without preventing the use of refractive treatments, such as rigid contact lenses and intracorneal rings. Get the whole story