Slowing the Progression of Keratoconus - Turning to Corneal Crosslinking

Riboflavin UV-A Corneal Crosslinking was developed in the 1990’s to treat progressive keratoconus. Its indication was rapidly extended to iatrogenic corneal ectasias. Conventional 3mW/cm2 CXL represents the gold standard therapy in multiple Countries around the World to halt the progression of early stages corneal ectasia demonstrating good long-term visual results and low complications. Early diagnosis, slowing the progression of keratoconus turning to native corneal crosslinking spirit: stabilizing ectasia progression preventing corneal shape modification, is the key. Conventional and Accelerated CXL protocols demonstrated a medium-long term improvement in visual and topo-aberrometric parameters. New conservative approaches such as topography-guided CXL and CXL-plus corneal reshaping techniques are under investigation for patients with poor spectacles corrected visual acuity and contact lenses intolerance before keratoplasty.