A recently published study confirms the fact that epithelium removal before corneal collagen crosslinking results in much better results than keeping the epithelium in place. Retaining the epithelium is an attractive option to surgeons due to the short term discomfort experienced by the patient due to epithelium removal. However keeping the epithelium on resulted in 46% of treatment failures in this study.
Epithelium-on cross-linking remains an attractive option, not least for patient comfort, however further research and adaptation of the technique with proof that it works is required before we widely offer it to patients. Until then epithelium-off crosslinking remains the superior proven technique.
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