Use of corneal cross-linking beyond keratoconus: a systemic literature review

Abstract

Purpose The success of corneal collagen cross-linking in altering keratoconus' clinical course has driven a search for further uses of this procedure. This literature review aims to analyze the scientific evidence available for the benefit of cross-linking in the management of ophthalmic diseases other than progressive keratoconus or ectasia induced by corneal refractive procedures. Methods A systemic literature review. ResultsWe reviewed 97 studies. We found that collagen cross-linking can limit the progression of several other corneal ectasias, thus reducing and limiting the need for keratoplasty. Collagen cross-linking also can reduce the refractive power of the cornea and can be considered for a moderate degree of bacterial keratitis or when the organism is unidentified, which is refractive to antibiotics alone. However, the comparative rarity of these procedures has limited the extent of evidence. In fungal, Acanthamoeba, and herpes virus keratitis, the evidence is inconclusive of the safety and efficacy of cross-linking. Conclusion Current clinical data is limited, and laboratory data has not fully correlated with published clinical data.

Contrast-Enhanced Micro-Ct 3d Visualization of Cell Distribution in Hydrated Human Cornea

“…The present study also opened the possibilities for evaluating the impact of pharmaceutical or therapeutic interventions on corneal swelling [54,55]. Subsequent research should focus on assessing the effectiveness of various treatment modalities, such as cross-linking for keratoconus or pharmacotherapy for corneal edema [56][57][58]. We also foresee further advances in corneal disease diagnostics, where one can identify correlations between specific structural shifts observed via micro-CT imaging and clinical manifestations of corneal diseases.…”

Contrast-enhanced Micro-CT 3D visualization of cell distribution in hydrated human cornea

“…The present study also opened the possibilities for evaluating the impact of pharmaceutical or therapeutic interventions on corneal swelling [ 54 , 55 ]. Subsequent research should focus on assessing the effectiveness of various treatment modalities, such as cross-linking for keratoconus or pharmacotherapy for corneal edema [ [56] , [57] , [58] ]. We also foresee further advances in corneal disease diagnostics, where one can identify correlations between specific structural shifts observed via micro-CT imaging and clinical manifestations of corneal diseases.…”

Herpes simplex keratitis: A brief clinical overview

“…It has been postulated that the ultraviolet radiation A light, damage to the epithelial/stroma trauma, or damage to the nerves of the cornea during the cornea cross-linking could result in recurrent HSV[ 236 , 237 ]. However, other authors have advocated for corneal cross-linking as a therapy for HSK[ 238 ].…”