Comparative Efficacy and Safety of Conventional Dresden, Transepithelial, and Accelerated Corneal Collagen Cross-Linking Protocols for Progressive Keratoconus: A Systematic Review

Key Points

• Conventional epi-off cross-linking showed the strongest evidence for stabilizing keratometry and preserving vision in progressive keratoconus.
• Accelerated protocols matched short-term efficacy of conventional methods while being more efficient, indicating practical benefits.
• Transepithelial approaches may suit certain patients preferring less invasive treatment despite potential long-term trade-offs.
• Findings highlight the need for tailored approaches to keratoconus treatment based on patient preferences and clinical goals.