Corneal collagen crosslinking: new horizons

Corneal collagen crosslinking using the photosensitzer riboflavin and UVA light has been introduced recently as an effective means of stabilizing the cornea in keratoconus and is currently entering mainstream use; the 6-year results have confirmed earlier positive results. Preoperative pachymetry to ensure a stromal thickness of at least 400 mu m and individual control of the UVA irradiance of 3 mW/cm(2) before each treatment are both mandatory to avoid serious risks. Complications such as keratitis, perforation or scarring are extremely rare. New applications of the technique are currently being explored, such as the treatment of post-laser in situ keratomileusis ectasia, pellucid marginal degeneration, therapy-refractive keratitis or bullous keratopathy. Thanks to crosslinking, the need for corneal transplantation should be reduced significantly in the future in various corneal disorders.