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Corneal collagen cross-linking for treating keratoconus: a systematic review and meta-analysis

Poster Details

First Author: E.Sykakis UK

Co Author(s):    R. Karim   S. Hamada                 

Abstract Details


The objective of this review was to assess whether there is evidence that CXL is an effective and safe treatment for halting the progression of keratoconus, based on the strict criteria used in Cochrane reviews


Corneoplastic Unit and Eye bank, Queen Victoria Hospital, East Grinstead, UK


We searched the Cochrane Central Register of Controlled Trials, Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE, EMBASE, Latin American and Caribbean Health Sciences Literature Database, Cumulative Index to Nursing and Allied Health Literature, OpenGrey, the metaRegister of Controlled Trials, and the World Health Organisation International Clinical Trials Registry Platform.


We included three RCTs that enrolled a total of 225 eyes and analysed 219 eyes. Out of the eyes analysed, 119 had CXL and 100 served as controls. In one study, eyes given CXL were less likely to have an increase in maximum keratometry of 1.5 D or more at 12 months compared to eyes given no treatment (RR 0.12, 95% CI 0.01 to 2.00). The same study reported the number of eyes with an increase of 2 D or more at 36 months in the whole cohort with a RR of 0.03 favouring CXL (95% CI 0.00 to 0.43). Another study reported progression at 18 months; but again the effect was uncertain (RR 0.14, 95% CI 0.01 to 2.61).


The evidence for the use of CXL in the management of keratoconus is limited due the lack of properly conducted RCTs.

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