Long-term Follow-up of Corneal Collagen Cross-linking for Keratoconus—The Cretan Study

Abstract

CXL seems to be effective and safe in halting progression of keratoconus over a long-term follow-up period up to 5 years postoperatively.

Corneal collagen cross-linking in paediatric patients affected by keratoconus

“…BSCVA remained stable in most eyes 2 years after treatment (60%), whereas 34% of eyes had an increase of one line or more. Three eyes (6%) had a reduction of BSCVA of one line, similar to data reported by Kymionis et al 21. Keratoconus progression after CXL occurred only in one patient.…”

Excessive Corneal Flattening and Thinning After Corneal Cross-linking

“…2 It has been revealed that the spherical equivalent is reduced after CXL treatment; however, the reduction seems to be statistically insignificant. 2 Another major metric that is not yet fully elucidated in the literature is the post-CXL pachymetric corneal change.…”

“…2 It has been revealed that the spherical equivalent is reduced after CXL treatment; however, the reduction seems to be statistically insignificant. 2 Another major metric that is not yet fully elucidated in the literature is the post-CXL pachymetric corneal change. Greenstein et al 3 reported that after CXL, the cornea tends to thin in the early postoperative period; however, it recovers toward baseline values during the first postoperative year.…”

“…1 It is a safe and effective treatment method in arresting keratoconus progression, whereas corneal flattening of the highly steep and irregular astigmatic corneas has been outlined. 2 Thus, CXL could possibly lead to visual acuity improvement and furthermore to better quality of the patient's life.…”

Effect of the Regenerative Agent Poly(Carboxymethylglucose Sulfate) on Corneal Wound Healing After Corneal Cross-Linking for Keratoconus

“…[1][2][3][4] The standard CXL protocol requires corneal epithelial removal, which retains the drawback of postoperative pain and the risk of epithelium-related complications such as infection and recurrent erosions. 4 Cacicol20 [poly(carboxymethyl glucose sulfate); OTR3, Paris, France] is a regenerative agent (RGTA) that has provided encouraging results in corneal lesions such as neurotrophic ulcers, chronic neurotrophic keratitis, and persistent epithelial defects.…”