Does cornea cross-linkage reduce the rate of corneal transplants in keratoconus?
Reviewed by Eulee Seow

Cornea cross-linking (CXL) is a relatively new treatment in the management of keratoconus, which may help prevent the need for corneal transplant. This paper investigates if the introduction of corneal cross-linkage has reduced the number of corneal transplants performed annually in the Netherlands. It reports that approximately 25% fewer corneal transplants were performed in the three-year period following the introduction of CXL compared to the three-year period prior to the introduction of CXL (201 versus 269 transplants, respectively; p=0.005). Age, gender and visual acuity were similar between the patient groups in the two time periods. Trend analysis also demonstrated a significant decrease in the amount of corneal transplants (p=0.001). Although cornea cross-linking is approved by National Institute of Health & Care Excellence (NICE), access to this treatment on the NHS is variable. This paper helps make the economic and quality of life argument for increasing availability of cornea cross-linkage on the NHS.

Nationwide reduction in the number of corneal transplantations for keratoconus following the implementation of cross-linking.
Godefrooij DA, Gans R, Imhof SM, Wisse RPL.
ACTA OPHTHALMOLOGICA
2016;94:675-8.