Epithelium-off photochemical corneal collagen cross-linkage using riboflavin and ultraviolet a for keratoconus and keratectasia: a systematic review and meta-analysis

source extracted confidence: high 2026-04-09
#collagen #corneal-stroma #cross-linking-reagents #humans #keratoconus

Epithelium-off photochemical corneal collagen cross-linkage using riboflavin and ultraviolet a for keratoconus and keratectasia: a systematic review and meta-analysis

Craig et al., 2014 | Ocul Surf | Meta Analysis

Citation

Craig Joyce A, Mahon James, ... Figueiredo Francisco. Epithelium-off photochemical corneal collagen cross-linkage using riboflavin and ultraviolet a for keratoconus and keratectasia: a systematic review and meta-analysis. Ocul Surf. 2014-Jul;12(3):202-14. doi:10.1016/j.jtos.2014.05.002

Abstract

This report presents the results of a systematic review and meta-analyses of studies on epithelium-off photochemical corneal collagen cross-linkage for the management of keratoconus and secondary ectasia. The literature search identified 3,400 records of which 49 were considered for inclusion in the meta-analyses. Eight papers reported 4 unique randomized controlled trials, 29 studies were prospective, and 12 were retrospective studies. The majority of the studies (39/49) were graded as very low quality evidence. Twenty-six studies described adverse events and were included in the safety analysis. Meta-analyses are presented for changes in four outcomes: visual acuity, topography, refraction and astigmatism, and central corneal thickness. Statistically significant improvements were found in all efficacy outcomes at 12 months after the operation. Common side effects were pain, corneal edema, and corneal haze, which resolved usually within a few days after the procedure. The remaining uncertainty is duration of benefit to establish the procedure's potential benefit in avoiding or delaying disease progression and possibly reducing the need for corneal transplantation.

Key Findings

The remaining uncertainty is duration of benefit to establish the procedure's potential benefit in avoiding or delaying disease progression and possibly reducing the need for corneal transplantation.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 29
Age Range See abstract
Condition See abstract

MeSH Terms

  • Collagen
  • Corneal Stroma
  • Cross-Linking Reagents
  • Humans
  • Keratoconus
  • Photosensitizing Agents
  • Riboflavin
  • Ultraviolet Rays
  • Ultraviolet Therapy

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Systematic Review
  • Vertical: collagen

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09