Corneal Cross-Linking

Corneal cross-linking (CXL) utilizes the photosensitizer riboflavin and ultraviolet-A (UV-A) light to induce the formation of strong linkage among the collagen fibers. This technique was first developed and tested successfully in vitro on both animal and human cornea in the late 1990s [1–3]. CXL was then shown to be effective in arresting the progression of moderate to advanced keratoconus and was associated with better visual acuity in a pilot study by Wollensak et al. in 2003 [4, 5]. Since then, many countries, including the United States in 2016, have approved the use of CXL with riboflavin and UV-A to treat keratoconus and other corneal ectatic conditions.