Corneal collagen cross-linking using riboflavin and ultraviolet-A irradiation: a review of clinical and experimental studies

Int Ophthalmol. 2011 Aug;31(4):309-19. doi: 10.1007/s10792-011-9460-x. Epub 2011 Aug 17.


Corneal collagen cross-linking (CXL) using riboflavin and ultraviolet-A irradiation is a common method of tissue stabilization and has been developed primarily to address the need of treating keratoconus. CXL's promising results on keratoconus indicated that it might be effective in other corneal diseases as well. This new treatment promises a slowing effect on the progression of these diseases and its initial results show that it is safe and reasonably curative. The purpose of this review is to critically evaluate this treatment, to explore its benefits, to highlight its limitations in terms of efficacy and long-term safety and finally to identify areas for future research in this topic with a significant potential to change the way we treat our patients. In addition, in this unbiased review we try to bring together all the scientific information from both laboratory and clinical trials that have been conducted during recent years and to review the most recent publications regarding the therapeutic indications of CXL.

Publication types

  • Review

MeSH terms

  • Animals
  • Collagen / radiation effects
  • Collagen / therapeutic use*
  • Corneal Diseases / therapy*
  • Cross-Linking Reagents / therapeutic use*
  • Humans
  • Photochemotherapy / methods*
  • Photosensitizing Agents / therapeutic use*
  • Riboflavin / therapeutic use*
  • Treatment Outcome
  • Ultraviolet Therapy / methods*


  • Cross-Linking Reagents
  • Photosensitizing Agents
  • Collagen
  • Riboflavin