Department of Ophthalmology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.
Curr Opin Ophthalmol. 2013 Jul;24(4):291-5. doi: 10.1097/ICU.0b013e3283622d51.
To describe the use of corneal collagen cross-linking (CXL) and its efficacy in the stabilization of keratorefractive procedures, including PRK, laser in-situ keratomileusis (LASIK), thermal keratoplasty, and orthokeratology.
Since its introduction, CXL has quickly gained interest in the treatment of ectactic disorders due to its ability to increase the biomechanical stability of the cornea. In its earliest use, it has shown to be effective in the treatment of both keratoconus and post-LASIK ectasia. More recent studies of CXL in combination with keratorefractive procedures have shown varying degrees of success.
CXL with PRK has shown to be effective in slowing or halting the progression of keratoconus, pellucid marginal degeneration, and post-LASIK ectasia, in addition to potentially decreasing or delaying the need for penetrating keratoplasty. Several small case series have also demonstrated improved stability and efficacy of PRK and LASIK when combined with CXL, as well as a potentially decreased risk of postprocedure ectasia. In conjunction with thermokeratoplasty and orthokeratology, CXL has shown improved but only temporary results in the treatment of keratoconus. Future studies are needed to determine the efficacy and long-term stability of CXL in combination with keratorefractive procedures, as well as to address possible complications.
描述角膜胶原交联术（CXL）的应用及其在稳定角膜屈光手术中的疗效，包括准分子激光角膜表面切削术（PRK）、激光原位角膜磨镶术（LASIK）、热角膜成形术和角膜塑形术。
自引入以来，由于能够增加角膜的生物力学稳定性，CXL 迅速成为治疗扩张性疾病的热点。在其早期应用中，它已被证明对治疗圆锥角膜和 LASIK 后扩张有效。最近对 CXL 联合角膜屈光手术的研究显示出不同程度的成功。
CXL 联合 PRK 已被证明可有效减缓或阻止圆锥角膜、后弹力层营养不良和 LASIK 后扩张的进展，此外还可能减少或延迟穿透性角膜移植的需求。几项小型病例系列研究还表明，CXL 联合 PRK 和 LASIK 可提高稳定性和疗效，并降低术后扩张的风险。与热角膜成形术和角膜塑形术联合使用时，CXL 可改善圆锥角膜的治疗效果，但仅为暂时效果。需要进一步的研究来确定 CXL 联合角膜屈光手术的疗效和长期稳定性，并解决可能的并发症。
