@article {1347439, title = {Transepithelial versus epithelium-off corneal crosslinking for corneal ectasia}, journal = {J Cataract Refract Surg}, volume = {44}, number = {12}, year = {2018}, month = {2018 Dec}, pages = {1507-1516}, abstract = {This review compared the clinical results of transepithelial corneal crosslinking (CXL) to epithelium-off (epi-off) CXL in progressive corneal ectasia using a metaanalysis. The Cochrane databases and Medline were searched for randomized controlled trials (RCTs). Seven RCTs involving 505 eyes that met the eligibility criteria were identified. The epi-off CXL group showed significantly better outcomes in postoperative changes in maximum keratometry (K) during 1-year observation periods. Transepithelial CXL resulted in significantly greater post-treatment central corneal thickness and best spectacle-corrected visual acuity (BSCVA). The presence of a postoperative demarcation line was significantly more frequent after epi-off CXL than that after transepithelial CXL. No statistically significant difference was found between other parameters. Although patients in the transepithelial CXL group demonstrated a greater improvement in BSCVA compared with patients in the epi-off CXL group at the 1\ year follow-up, transepithelial CXL had less impact on halting progressive corneal ectasia in terms of maximum K than epi-off CXL.}, issn = {1873-4502}, doi = {10.1016/j.jcrs.2018.08.021}, author = {Kobashi, Hidenaga and Rong, Shi Song and Ciolino, Joseph B} }