Clinical Application and Decision-making

Patient selection for corneal collagen cross-linking: an updated review

“…Recently, Frucht-Pery and Wajnsztajn 97 indicated that most of their patients undergoing CXL in the last 2 years have been diagnosed only several months earlier, because they do not wait for progression to happen if the patient is in a high-risk group, especially children and adolescents. However, they also stated that a case-by-case assessment is required to weigh the risks against the benefits of the surgery.…”

Corneal Collagen Crosslinking for Keratoconus: An update

“…CXL is now an established treatment option for such progressive cases of KC. Currently followed international guidelines described at the 7th International CXL Meeting (www.cxl-congress.com) at Milan in 2011 are: CXL is indicated in any patient younger than 27 years with ectatic disease, while patient older than 27 years can be monitored for signs of progression most commonly defined as 8 : Increase of 1 D of maximum K-reading (Kmax) or increase of manifest cylinder and/or deterioration of corrected distance visual acuity (CDVA) within 1 year AND contact-lens-dioptric changes which require replacement every 2 years or less. The criteria of "progression" followed in various studies (Table 1) Medications include: Topical moxifloxacin hydrochloride drops TDS for one week, topical carboxymethylcellulose sodium drops QID for one month.…”