Is accelerated corneal collagen cross-linking for keratoconus the way forward? No

Comparison of the Central and Peripheral Corneal Stromal Demarcation Line Depth in Conventional Versus Accelerated Collagen Cross-Linking

“…[8][9][10][11][12] Currently, there is still a debate on the effectiveness between conventional CXL and its accelerated counterparts. 13,14 A corneal stromal demarcation line indicating the transition between the anterior cross-linked and posterior untreated corneal stroma could be observed using a slit lamp by as early as 2 weeks after CXL. 15 The depth of this line has been postulated as an indirect measurement of cross-linking effectiveness.…”

Corneal Collagen Cross-linking

“…A few clinical studies also demonstrated the treatment efficacy and safety of these accelerated protocols, 9Y12 although no general consensus on this form of treatment has been made. 13,14 thickness. Subsequently, the cornea is photoactivated using identical treatment parameters as described previously.…”

Fellow eye effect of unilateral intravitreal anti-VEGF injections in eyes with diabetic macular edema

“…While I congratulate the Journal for encouraging such interesting debates and the authors for their hard work in presenting their points of view, I feel it is necessary to point out two inaccuracies presented and repeated in both articles. 1,2 The first is equating the degree, depth, and safety of cross-linking to the depth of the demarcation line. There is currently no evidence to support this direct correlation.…”

“…2 Ranibizumab is a 48-kDa antigen-binding fragment, which lacks a fragment crystallizable (Fc) region and is rapidly cleared from the systemic circulation. 3 Our retrospective study suggests clinically meaningful contralateral effect in more than a quarter of patients treated with bevacizumab, a 150-kDa monoclonal antibody containing an Fc region.…”