Table 1. Systematic review of efficacy of epithelial removal (ER) corneal collagen crosslinking.
| Lead Author | Year | Study design | Eyes at latest follow-up (n) | Age (years) (mean ±SD) (range) | Latest follow-up (month) (mean±SD) (Range) | Mean UDVA change (logMAR) | Mean CDVA change (logMAR) | MSE change (D) | Cylinder change (D) | K max change (D) | Pachymetry change (microns) | Failure (%) | Retreatment (%) | DALK (%) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Agrawal V9 | 2009 | CSa | 37 | 16.9±6.35 (12–39) | 12 | — | −0.09 | — | −1.20 | −2.47 | — | 8.1 | — | — |
| Arora R70 | 2013 | CS | 30 | 16 (12–18) | 12 | −0.18b | −0.12b | — | — | 0.4b | −66.46b | — | — | — |
| Asri D69 | 2011 | CS | 64 | 24.12±7.58 | 12 | 0.00 | −0.01 | — | +0.07 | −0.49 | −11 | 9.8 | — | 6.25 |
| Caporossi A4 | 2010 | CS | 44 | 10–40 | 48 | −0.37 | −0.14 | +2.15 | −0.55 | −2.26 | +0.6 | — | — | — |
| Caporossi A68 | 2012 | CS | 77 | 10–18 | 36 | −0.15 | −0.09 | — | — | −0.72 | — | — | — | — |
| Ghanem R67 | 2013 | CS | 42 | 22.4±5.6 (14–34) | 24 | −0.24 | −0.12 | 0.39 | 0.46 | −0.9 | — | — | — | — |
| Greenstein S66 | 2010 | CS | 31 | 32.3±10.3 (15–52) | 12 | — | — | — | — | — | — | — | — | |
| Greenstein S71 | 2011 | CS | 54 | No data | 12 | — | — | — | — | — | −12.1 | — | — | — |
| Greenstein S7 | 2012 | CS | 64 | No data | 12 | — | — | — | — | — | — | — | — | — |
| Greenstein S65 | 2012 | CS | 46 | No data | 12 | — | — | — | — | — | — | — | — | — |
| Greenstein S64 | 2012 | CS | 66 | No data | 12 | −0.08 | −0.10 | — | — | −1.60 | — | — | — | — |
| Grewal D63 | 2009 | CS | 102 | 25.6±4.5 (18–31) | 12 | — | −0.02 | +1.43 | −0.17 | — | −3.7 | — | — | — |
| Guber I62 | 2013 | CS | 33 | 26.36±7.62 (13–40) | 12 | — | −0.04 | — | 0.73 | −0.16 | −11.33 | — | — | — |
| Hashemi H61 | 2013 | CS | 40 | 22.45±5.48 (16–35) | 60 | −0.02 | −0.12 | 0.41 | 0.65 | −0.24 | 2 | — | — | — |
| Hassan Z60 | 2013 | CS | 38 | 29.36±9.7 (16–42) | 36 | −0.17 | −0.09 | −0.55 | — | — | — | — | — | |
| Hersh P10 | 2011 | CS | 49 | No data | 12 | −0.05 | −0.14 | +0.85 | −0.08 | −2.00 | — | — | — | — |
| Hoyer A59 | 2009 | CS | 35 | 27.92±17.15 | 36 | — | −0.14 | — | −1.64 | −2.73 | — | 8.6 | 8.6 | — |
| Ivarson A58 | 2013 | CS | 28 | 12–38 | 22±8 (10–43) | — | −0.07 | — | — | 1.1 | −0.52 | — | — | — |
| Jordan C57 | 2013 | CS | 38 | 21.9±6.0 | 12 | — | — | — | — | — | — | — | — | — |
| Kampik D56 | 2011 | CS | 46 | 33.5±9.9 | 24 | — | −0.05 | — | — | −1.23 | −21.6 | — | — | — |
| Kontadakis G55 | 2013 | CS | 24 | 25±4.7 (20–36) | 24 | — | — | — | — | — | — | — | — | — |
| Kranitz K11 | 2012 | CS | 25 | 29.92 | 12 | −0.13 | −0.09 | +1.32 | −0.49 | −1.68 | −31 | — | — | — |
| Kymionis G54 | 2010 | CS | 55 | 24.4±4.1 (18–36) | 12 | — | — | — | — | — | — | — | — | — |
| Lamy R53 | 2013 | CS | 68 | 24.4 (18–33) | 24 | — | −0.16 | — | — | −0.99 | — | |||
| Legare M52 | 2013 | CS | 39 | 26.8±10.3 (15–56) | 15.8 | 0.18 (12 months)c | 0 (at 24 months)c | 1.55 (at 24 months)c | 1.30 (at 24 months)c | — | −15.58 (at 24 months) | — | — | — |
| Magli A51 | 2013 | Comparative CS (ER vs TE) | 23 | 14.75±2.1 (12–18) | 12 | −0.01 | 0.01 | — | 0.11 | −1.14 | −1.98 | — | — | — |
| Mastropasqua L36 | 2013 | RCT (ER vs TE) | 20 | 23±2.5 (16–23) | 12 | — | — | — | — | 37 | — | — | — | |
| Mazzotta C49 | 2008 | CS | 44 | No data | 36 | — | — | — | — | — | — | — | — | — |
| Mazzotta C50 | 2012 | CS | 44 | No data | 12 | −0.19 | −0.11 | — | — | −0.30 | +14.5 | — | — | — |
| Mencucci R48 | 2012 | CS | 54 | 26.2±7 | 12 | — | — | — | — | — | +1 | — | — | — |
| O'Brart D8 | 2011 | RCT (ER vs observation) | 24 | 29.6 (21–42) | 18 | −0.08 | +0.06 | +0.82 | −0.5 | −0.62 | +3.4 | — | — | — |
| O'Brart D47 | 2013 | CS | 30 | 26.3 (12–40) | 53.3 (48 to 72) | 0.03 | 0.05 | 0.82 | 0.28 | — | 3 | |||
| Poli M46 | 2013 | CS | 45 | 26±7.3 (15–46) | 21.7±6.14 | −0.2 (at 12 months) | −0.23 (at 36 months) | — | — | −0.14 (at 2 years) | −0.24 | — | — | — |
| Raiskup-Wolf F44 | 2008 | CS | 33 | 30.04±10.46 | 36 | — | −0.15 | — | −1.45 | −2.57 | — | 33.3 | 5.4 | — |
| Raiskup F45 | 2009 | CS | 163 | 31.53±8.58 | 12 | — | 0.05 | — | — | −0.75 | — | — | — | — |
| Raiskup F5 | 2011 | CS | 32 | 27.4±9.4 | 12 | — | −0.04 | — | — | −0.7 | — | — | — | — |
| Rechichi M43 | 2013 | Comparative CS (Fellow eye with no treatment as control) | 28 | 28.8 (18–41 years) | 12 | 0.25 | −0.05 | 0.96 | 0.99 | — | −15 | — | — | — |
| Sloot F42 | 2013 | CS | 53b | 21.5 (12–49) | 12 | — | −0.13b | — | — | −1.5b | −9b | 9% (5 of 53)b | ||
| Spoerl E41 | 2011 | CS | 50 | 29.4±9.3 (16–45) | 12 | — | — | — | — | — | — | — | — | — |
| Toprak I40 | 2013 | CS | 59 | 28.7±9.0 | 12 | — | −0.13 | — | — | −0.84 | — | — | — | — |
| Vinciguerra P37 | 2009 | CS | 28 | 24–52 | 24 | −0.24 | −0.15 | +0.81 | −0.34 | −1.35 | −8.1 | — | — | — |
| Vinciguerra P38 | 2009 | CS | 28 | 24–52 | 12 | −0.20 | −0.14 | +0.41 | −0.26 | −6.16 | −14.9 | — | — | — |
| Vinciguerra P39 | 2010 | CS | 24 | 15–36 | 12 | — | −0.73 | +11.0 | — | — | — | |||
| Vinciguerra P6 | 2012 | CS | 40 | 14.2±1.7 (9–18) | 24 | −0.21 | −0.19 | +1.57 | −1.31 | −1.27 | +14.0 | — | — | — |
| Wittig-Silva C35 | 2014 | RCT (ER vs observation) | 46 | 25.6±6.2 | 36 | −0.15 | −0.09 | −0.61 | −0.90 | −1.03 | 5.86 |
Abbreviations: CDVA, Corrected Distance Visual Acuity; DALK, deep anterior lamellar keratoplasty; ER, epithelial removal; K, keratometry; MSE, mean spherical equivalent; RCT, randomised controlled trial; SD, standard deviation; TE, transepithelial removal; UDVA, uncorrected visual acuity.
a
Case series.
b
Mean of all eyes in all groups.
c
Extrapolated from graphical data.