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Meta-Analysis
. 2014 Jul 10:4:5652.
doi: 10.1038/srep05652.

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

Tian Chunyu  1 , Peng Xiujun  1 , Fan Zhengjun  1 , Zhang Xia  1 , Zhou Feihu  2
Affiliations
Meta-Analysis

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

Tian Chunyu et al. Sci Rep. .

Abstract

The aim of this study was to determine the effectiveness of corneal collagen cross-linking (CXL) for the treatment of progressive keratoconus (KC). Some of the published literature, including a few small, randomized controlled trials (RCTs), demonstrated good results after CXL, but large RCTs with long-term follow-up to establish a cause-effect relationship are lacking. Using PubMed, EMBASE, and the Cochrane Library database, we searched for relevant studies published between October 2007 and March 2014. A comprehensive literature search was performed using the Cochrane Collaboration methodology to identify the effectiveness of CXL for treating KC. The primary outcome parameters included uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), refraction, corneal topography, and corneal thickness at baseline and at 1, 3, 6, 12, and 18 months after CXL. A total of 1171 participants (1557 eyes) were enrolled in this meta-analysis. CXL may be effective in halting the progress of KC for at least 12 months under certain conditions. However, further research from randomized trials is needed to confirm our findings.

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Conflict of interest statement

The authors declare no competing financial interests.

Figures

Figure 1
Figure 1. Flow diagram of study selection.
Figure 2
Figure 2. The clinical results at 18 months post-CXL treatment.
UCVA = uncorrected visual acuity, BCVA = best-corrected visual acuity, MRSE = mean refractive spherical equivalent, Kmax, Kave, CCT = central corneal thickness, ECD = endothelial cell density.
Figure 3
Figure 3. Funnel plot of long-term results after CXL treatment.
See this image and copyright information in PMC

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