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| LETTER TO THE EDITOR |
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| Year : 2021 | Volume
: 53
| Issue : 2 | Page : 173 |
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Unmet needs of corneal collagen cross-linking
Tapasya Singha
Attar Sain Jain Hospital, New Delhi, India
| Date of Submission | 21-Jul-2019 |
| Date of Decision | 07-Oct-2019 |
| Date of Acceptance | 26-Apr-2021 |
| Date of Web Publication | 26-May-2021 |
Correspondence Address:
Dr. Tapasya Singha
Attar Sain Jain Hospital, Lawrence Road, New Delhi - 110 035
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ijp.IJP_450_19
How to cite this article:
Singha T. Unmet needs of corneal collagen cross-linking. Indian J Pharmacol 2021;53:173 |
Sir,
The study titled, “Safety and efficacy of riboflavin assisted collagen cross-linking of cornea in progressive keratoconus patients: A prospective study in North East India” by Bhattacharyya et al., has been nicely conducted by the authors.[1] The two novelty factors addressed by the authors were evaluation in “north eastern participants” and use of “progressive keratoconus” population. Again, this study is one of the few studies addressing contrast sensitivity issue. Collagen cross-linking (CXL) is a rapidly progressing and relatively new field. In this context, I want to highlight some unmet needs in the field of corneal collagen cross-linking.
- Dresden protocol uses two agents (riboflavin + UV-A) for corneal collagen cross-linking, and it is unknown whether cross-linking is a primary effect of riboflavin or UV-A and individual effect sizes of the two agents are not evaluated clinically till now[2]
- Till now, only one study has evaluated the long-term outcome of corneal CXL procedure (retrospective analysis of data 10 years duration).[3] We need more long-term studies for the evaluation of long-term visual and topographic outcomes and need of repeat cross-linking in both keratoconus and progressive population
- Comparative efficacy and safety of different cross-linking protocols need to be evaluated in randomized controlled trial settings for evidence-based selection of a single protocol
- Anterior segment optical coherence tomography-based detailed evaluation of C3R patients on different protocols and their correlation to vision may be done
- Comparative evaluation of different riboflavin formulation and their comparative penetration and therapeutic efficacy may be addressed in further studies.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| » References | |  |
| 1. | Bhattacharyya A, Sarma P, Das K, Agarwal B, Medhi J, Das Mohapatra SS. Safety and efficacy of riboflavin-assisted collagen cross-linking of cornea in progressive keratoconus patients: A prospective study in North East India. Indian J Pharmacol 2019;51:157-67.  [Full text] |
| 2. | Wollensak G. Crosslinking treatment of progressive keratoconus: New hope. Curr Opin Ophthalmol 2006;17:356-60. |
| 3. | Theuring A, Spoerl E, Pillunat LE, Raiskup F. Corneal collagen cross-linking with riboflavin and ultraviolet-A light in progressive keratoconus. Results after 10-year follow-up. Ophthalmologe 2015;112:140-7. |
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