“Vital” Eye Research Review: What is collagen crosslinking for keratoconus?

Branching Chain Links

Collagen crosslinking is a procedure that has been performed in other areas of the world for many years but was approved by the FDA in the United States in 2016. The procedure aims to stiffen and strengthen the cornea by using riboflavin and ultraviolet light. This has been shown to be useful in the treatment of keratoconus because, in addition to helping to prevent progression of the cone, it also causes some flattening of the cone. Because we all tend to get stiffer corneas as we age, the procedure tends to be most helpful in patients under 40 years old who show signs of progressing keratoconus.

Cochrane is an international group of researchers that review studies (peer-reviewed evidence) to make healthcare decisions better. I value the reviews published by Cochrane because of their comprehensive review methodology and their unbiased reporting of findings.

Three studies were reviewed by Cochrane up to August 2014 with the following opinion:

Key results

“Eyes treated with CXL were less likely to have problems with the progression of bulging compared to eyes that were not treated. However, the studies were small and there were some concerns about the way they were done. It is therefore difficult to say exactly how much the treatment helped. None of the studies reported the risk of eyesight getting worse but, on average, treated eyes had better vision (about 10 letters better) compared to untreated eyes. None of the studies reported on a change in quality of life for the participant. The main adverse effects were inflammation and swelling; this occurred in approximately one in 10 participants.”

Their full opinion can be accessed here: Cochrane opinion on collagen crosslinking

If you have keratoconus that is worsening and would like more information on cross-linking, come in for an evaluation. Additionally, you can visit the National Keratoconus Foundation website at: National Keratoconus Foundation

Information from Dr. Vital on keratoconus