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

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

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

Manns et al., 2023 | Graefes Arch Clin Exp Ophthalmol | Systematic Review

Citation

Manns Richard P C, Achiron Asaf, ... Avadhanam Venkata S. Use of corneal cross-linking beyond keratoconus: a systemic literature review. Graefes Arch Clin Exp Ophthalmol. 2023-Sep;261(9):2435-2453. doi:10.1007/s00417-023-05994-6

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. RESULTS: We 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.

Key Findings

We 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, Acan

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 97
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Collagen
  • Corneal Cross-Linking
  • Cross-Linking Reagents
  • Keratitis, Herpetic
  • Keratoconus
  • Photochemotherapy
  • Photosensitizing Agents
  • Riboflavin
  • Ultraviolet Rays

Evidence Classification

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

Provenance

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