Müller P L, Löffler K U, Kohlhaas M, Holz F G, Herwig-Carl M C
Universitäts-Augenklinik Bonn, Bonn, Deutschland.
Sektion Ophthalmopathologie, Universitäts-Augenklinik Bonn, Bonn, Deutschland.
Klin Monbl Augenheilkd. 2018 Jul;235(7):809-819. doi: 10.1055/s-0043-102577. Epub 2017 May 3.
Keratoconus is a relatively common (1 : 2000) bilateral disease leading to a change in biochemical and biomechanical corneal structure as well as thinning and ectasia. For more than 10 years, crosslinking has been a therapeutic option in cases of progression. Using riboflavin and UVA-radiation, the anterior corneal stroma (300 µm) gets stiffened by crosslinking of collagen fibers. When protocols and limitations are adhered, the procedure is described to be effective and of low-risk. This review gives an overview about physiologic and pathologic changes in keratoconic corneas before and after crosslinking. Based on histopathologic examination, the current knowledge in published literature is reviewed and is complemented by our own investigations.