Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Curr Opin Ophthalmol. 2021 Jul 1;32(4):343-347. doi: 10.1097/ICU.0000000000000765.
Corneal collagen crosslinking (CXL) is a minimally invasive treatment that can stabilize corneal ectatic disorders including keratoconus, pellucid marginal degeneration, or postrefractive surgery ectasia. The benefits of CXL have been well documented. New research is focused on modifying current treatment protocols with the goals of maximizing corneal stability while also shortening overall procedure time.
Accelerated CXL protocols have the goal of delivering the same ultraviolet A intensity as conventional protocols, but over a shorter time period. Accelerated protocols have shown success to date, but there are concerns for long-term corneal stability. Pulsed protocols may increase the long-term efficacy of the accelerated designs. In addition, transepithelial crosslinking protocols have been designed with the goal of reducing postoperative pain and lower the risk of infectious complications of epithelial-off conventional protocols.
Newer CXL protocols attempt to make the procedure safer and more effective. Current research is promising, but long-term studies are essential to understand how the new protocols may affect corneal stability.
角膜胶原交联（CXL）是一种微创治疗方法，可稳定包括圆锥角膜、边缘性角膜变性或屈光手术后扩张等角膜扩张性疾病。CXL 的益处已得到充分证实。目前的研究重点是修改当前的治疗方案，目标是在保持角膜稳定性的同时缩短整体手术时间。
加速 CXL 方案的目标是在更短的时间内提供与传统方案相同的紫外线 A 强度。加速方案迄今为止已取得成功，但人们对长期角膜稳定性仍存在担忧。脉冲方案可能会增加加速设计的长期疗效。此外，设计经上皮交联方案的目的是减少术后疼痛并降低传统上皮下方案感染并发症的风险。
新型 CXL 方案试图使该程序更安全、更有效。目前的研究很有前景，但需要进行长期研究才能了解新方案可能如何影响角膜稳定性。
