Corneal collagen crosslinking: from basic research to clinical application

Corneal collagen crosslinking is a promising new treatment of progressive corneal ectasia. Its clinical use has been rapidly increasing since it was originally introduced in 1997 as the first treatment that can improve biomechanical stability of the weakened cornea. The method is based on the combined action of photosensitizer riboflavin (vitamin B2) and ultraviolet A light, which induce the formation of new covalent bonds between the collagen fibers. Our systematic search of literature in English has yielded only eight prospective trials with the efficiency and safety data published to date. However, all of the published studies reveal a halt in the progression or a slight improvement of corneal ectasia with the low complication and failure rates after the treatment. In this review we are highlighting the method's history, scientific basis and its current clinical application in order to provide clinicians with the recent data on its benefits and potential risks.