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Collagen Cross Linking in Keratoconus: A Review

Received: 31 October 2016    Accepted: 29 November 2016    Published: 3 January 2017
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Abstract

Corneal collagen cross-linking (CXL) is a therapeutic procedure that helps in increasing the corneal stiffness in the keratoconus eyes. It increases the collagen cross linking within the extracellular matrix (ECM). Ultraviolet-A (370 nm) irradiation of the cornea after saturation with the photosensitizer riboflavin is used. A minimum deepithelialized corneal thickness of 400 μm is recommended to avoid potential irradiation damage to the corneal endothelium but in advanced cases this is not achieved which limits the application of CXL in that category. Modifications have been done in the conventional CXL procedure to be applicable in thin corneas. The current review discusses different techniques employed to achieve this end and their results. The modifications in CXL halt the progression of keratectasia without postoperative complications. However, the evidence of safety and efficacy in the use of modified CXL protocols is still limited to few studies with few patients involved. Controlled studies with long-term follow-up are required to confirm the safety and efficacy of the modified protocols.

Published in International Journal of Ophthalmology & Visual Science (Volume 1, Issue 1)
DOI 10.11648/j.ijovs.20160101.13
Page(s) 20-24
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Keratoconus, Collagen Cross Linking, Thin Cornea

References
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Cite This Article
  • APA Style

    Bhavesh Makkar, Deepak Mishra. (2017). Collagen Cross Linking in Keratoconus: A Review. International Journal of Ophthalmology & Visual Science, 1(1), 20-24. https://doi.org/10.11648/j.ijovs.20160101.13

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    ACS Style

    Bhavesh Makkar; Deepak Mishra. Collagen Cross Linking in Keratoconus: A Review. Int. J. Ophthalmol. Vis. Sci. 2017, 1(1), 20-24. doi: 10.11648/j.ijovs.20160101.13

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    AMA Style

    Bhavesh Makkar, Deepak Mishra. Collagen Cross Linking in Keratoconus: A Review. Int J Ophthalmol Vis Sci. 2017;1(1):20-24. doi: 10.11648/j.ijovs.20160101.13

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  • @article{10.11648/j.ijovs.20160101.13,
      author = {Bhavesh Makkar and Deepak Mishra},
      title = {Collagen Cross Linking in Keratoconus: A Review},
      journal = {International Journal of Ophthalmology & Visual Science},
      volume = {1},
      number = {1},
      pages = {20-24},
      doi = {10.11648/j.ijovs.20160101.13},
      url = {https://doi.org/10.11648/j.ijovs.20160101.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20160101.13},
      abstract = {Corneal collagen cross-linking (CXL) is a therapeutic procedure that helps in increasing the corneal stiffness in the keratoconus eyes. It increases the collagen cross linking within the extracellular matrix (ECM). Ultraviolet-A (370 nm) irradiation of the cornea after saturation with the photosensitizer riboflavin is used. A minimum deepithelialized corneal thickness of 400 μm is recommended to avoid potential irradiation damage to the corneal endothelium but in advanced cases this is not achieved which limits the application of CXL in that category. Modifications have been done in the conventional CXL procedure to be applicable in thin corneas. The current review discusses different techniques employed to achieve this end and their results. The modifications in CXL halt the progression of keratectasia without postoperative complications. However, the evidence of safety and efficacy in the use of modified CXL protocols is still limited to few studies with few patients involved. Controlled studies with long-term follow-up are required to confirm the safety and efficacy of the modified protocols.},
     year = {2017}
    }
    

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    T1  - Collagen Cross Linking in Keratoconus: A Review
    AU  - Bhavesh Makkar
    AU  - Deepak Mishra
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    DO  - 10.11648/j.ijovs.20160101.13
    T2  - International Journal of Ophthalmology & Visual Science
    JF  - International Journal of Ophthalmology & Visual Science
    JO  - International Journal of Ophthalmology & Visual Science
    SP  - 20
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    PB  - Science Publishing Group
    SN  - 2637-3858
    UR  - https://doi.org/10.11648/j.ijovs.20160101.13
    AB  - Corneal collagen cross-linking (CXL) is a therapeutic procedure that helps in increasing the corneal stiffness in the keratoconus eyes. It increases the collagen cross linking within the extracellular matrix (ECM). Ultraviolet-A (370 nm) irradiation of the cornea after saturation with the photosensitizer riboflavin is used. A minimum deepithelialized corneal thickness of 400 μm is recommended to avoid potential irradiation damage to the corneal endothelium but in advanced cases this is not achieved which limits the application of CXL in that category. Modifications have been done in the conventional CXL procedure to be applicable in thin corneas. The current review discusses different techniques employed to achieve this end and their results. The modifications in CXL halt the progression of keratectasia without postoperative complications. However, the evidence of safety and efficacy in the use of modified CXL protocols is still limited to few studies with few patients involved. Controlled studies with long-term follow-up are required to confirm the safety and efficacy of the modified protocols.
    VL  - 1
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Author Information
  • Department of Ophthalmology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India

  • Department of Ophthalmology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India

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