Middle East African Journal of Ophthalmology

: 2010  |  Volume : 17  |  Issue : 1  |  Page : 21--27

Corneal collagen cross-linking

Mirko R Jankov II1, Vesna Jovanovic2, Ljubisa Nikolic3, Jonathan C Lake4, Georgos Kymionis5, Efekan Coskunseven6 
1 Laser Focus-Centre for Eye Microsurgery, Belgrade, Serbia
2 Laser Focus-Centre for Eye Microsurgery, , Belgrade, Serbia
3 KBC Zvezdara, Belgrade, Serbia
4 OFTALMED Hospital da Visão de Brasilia, Brasilia, Brazil
5 Institute of Vision and Optics, Department of Medicine, University of Crete, Crete, Greece
6 Dunya Eye Hospital, Istanbul, Turkey

Correspondence Address:
Mirko R Jankov II
Laser Focus-Centre for Eye Microsurgery, 25, Cara Nikolaja II Str, 11000 Belgrade

Corneal collagen cross-linking (CXL) with riboflavin and ultraviolet-A (UVA) is a new technique of corneal tissue strengthening by using riboflavin as a photosensitizer and UVA to increase the formation of intra- and interfibrillar covalent bonds by photosensitized oxidation. Keratocyte apoptosis in the anterior segment of the corneal stroma all the way down to a depth of about 300 microns has been described and a demarcation line between the treated and untreated cornea has been clearly shown. It is important to ensure that the cytotoxic threshold for the endothelium has not been exceeded by strictly respecting the minimal corneal thickness. Confocal microscopy studies show that repopulation of keratocytes is already visible 1 month after the treatment, reaching its pre-operative quantity and quality in terms of functional morphology within 6 months after the treatment. The major indication for the use of CXL is to inhibit the progression of corneal ectasias, such as keratoconus and pellucid marginal degeneration. CXL may also be effective in the treatment and prophylaxis of iatrogenic keratectasia, resulting from excessively aggressive photoablation. This treatment has also been used to treat infectious corneal ulcers with apparent favorable results. Combination with other treatments, such as intracorneal ring segment implantation, limited topography-guided photoablation and conductive keratoplasty have been used with different levels of success.

How to cite this article:
Jankov II MR, Jovanovic V, Nikolic L, Lake JC, Kymionis G, Coskunseven E. Corneal collagen cross-linking.Middle East Afr J Ophthalmol 2010;17:21-27

How to cite this URL:
Jankov II MR, Jovanovic V, Nikolic L, Lake JC, Kymionis G, Coskunseven E. Corneal collagen cross-linking. Middle East Afr J Ophthalmol [serial online] 2010 [cited 2019 Oct 15 ];17:21-27
Available from: http://www.meajo.org/article.asp?issn=0974-9233;year=2010;volume=17;issue=1;spage=21;epage=27;aulast=Jankov;type=0