Corneal Collagen Cross-Linking for Keratoconus: Systematic Review

source extracted confidence: high 2026-04-09
#case-control-studies #collagen #cornea #corneal-pachymetry #cross-linking-reagents

Corneal Collagen Cross-Linking for Keratoconus: Systematic Review

Kobashi et al., 2017 | Biomed Res Int | Meta Analysis

Citation

Kobashi Hidenaga, Rong Shi Song. Corneal Collagen Cross-Linking for Keratoconus: Systematic Review. Biomed Res Int. 2017;2017:8145651. doi:10.1155/2017/8145651

Abstract

PURPOSE: To evaluate the efficacy of collagen cross-linking (CXL) one year after treatment for keratoconus compared to no treatment by summarizing randomized controlled trials (RCTs) using a systematic review. METHODS: Trials meeting the selection criteria were quality appraised, and the data were extracted by two independent authors. The outcome parameters included maximum keratometry (Kmax), corneal thickness at the thinnest point, best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity (UCVA), spherical equivalent (SE) refraction, and cylindrical refraction one year after CXL. We compared the changes in the above parameters with the control group. RESULTS: We identified five RCTs involving 289 eyes that met the eligibility criteria for this systematic review. The changes in BSCVA from baseline to one year exhibited a significant difference between the two groups. There was no statistically significant difference between the two groups for changes in corneal thickness and cylindrical refraction. We did not conduct a meta-analysis in Kmax, UCVA, and SE refraction because their I2 values were greater than 50%. CONCLUSIONS: According to the systematic review, CXL may be effective in halting the progression of keratoconus for one year under certain conditions, although evidence is limited due to the significant heterogeneity and paucity of RCTs.

Key Findings

We identified five RCTs involving 289 eyes that met the eligibility criteria for this systematic review. The changes in BSCVA from baseline to one year exhibited a significant difference between the two groups. There was no statistically significant difference between the two groups for changes in corneal thickness and cylindrical refraction. We did not conduct a meta-analysis in Kmax, UCVA, and SE refraction because their I2 values were greater than 50%.

Outcomes Measured

  • Requires manual extraction

Population

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

MeSH Terms

  • Case-Control Studies
  • Collagen
  • Cornea
  • Corneal Pachymetry
  • Cross-Linking Reagents
  • Humans
  • Keratoconus
  • Publication Bias
  • Randomized Controlled Trials as Topic
  • Refraction, Ocular
  • Treatment Outcome
  • Visual Acuity

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: collagen

Provenance

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