Safety and efficiency criteria of corneal crosslinking in laser refractive corneal surgery

The paper considers the criteria for the safety and effectiveness of various methods of corneal crosslinking. To do this, we analyzed literature data on the complications of corneal crosslinking and our own results of preventive (590 operations) and therapeutic (110 operations) excimer laser corneal crosslinking in terms of 1 month to 9 years. A comprehensive ophthalmological examination, OCT, densitometry, and assessment of the state of the cornea according to optical scanning data in the visible and infrared ranges were performed. Clinically significant complications of corneal crosslinking were hydrops, infectious corneal ulcer, sterile infiltrates, and corneal opacities. The above complications were not observed during prophylactic and therapeutic excimer laser corneal crosslinking. Observations have shown that the criteria for the effectiveness of therapeutic crosslinking of the cornea should be considered stabilization or improvement of keratometric parameters. The main efficacy criteria for preventive crosslinking in laser refractive corneal surgery were the absence of deviations from the target refraction, complete restoration of corneal transparency, and stable keratometric parameters. The safety of one or another crosslinking technique was evidenced by the absence of corneal complications in the early and long-term follow-up periods.