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Year : 2021  |  Volume : 53  |  Issue : 2  |  Page : 173-

Unmet needs of corneal collagen cross-linking

Tapasya Singha 
 Attar Sain Jain Hospital, New Delhi, India

Correspondence Address:
Dr. Tapasya Singha
Attar Sain Jain Hospital, Lawrence Road, New Delhi - 110 035

How to cite this article:
Singha T. Unmet needs of corneal collagen cross-linking.Indian J Pharmacol 2021;53:173-173

How to cite this URL:
Singha T. Unmet needs of corneal collagen cross-linking. Indian J Pharmacol [serial online] 2021 [cited 2023 Feb 6 ];53:173-173
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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 populationComparative efficacy and safety of different cross-linking protocols need to be evaluated in randomized controlled trial settings for evidence-based selection of a single protocolAnterior segment optical coherence tomography-based detailed evaluation of C3R patients on different protocols and their correlation to vision may be doneComparative evaluation of different riboflavin formulation and their comparative penetration and therapeutic efficacy may be addressed in further studies.

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1Bhattacharyya 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.
2Wollensak G. Crosslinking treatment of progressive keratoconus: New hope. Curr Opin Ophthalmol 2006;17:356-60.
3Theuring 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.