Corneal Collagen Cross Linking

The first of its kind, this comprehensive book, Corneal Collagen Cross-Linking, brings together cross-linking theory, treatment, outcomes, complications and their management.

Corneal Collagen Cross-Linking provides a concise yet comprehensive summary of the cross-linking (CXL) process, including the basic science foundations, treatment protocols and outcomes, recognition and management of potential complications, and modifications of the standard protocol for special circumstances.

Inside the pages of Corneal Collagen Cross-Linking, Dr. Farhad Hafezi and Dr. J. Bradley Randleman include the latest available information on CXL and additional clinical applications, including CXL for infectious keratitis and corneal edema, CXL combined with other treatments for improved refractive outcomes in patients with keratoconus and ectasia after LASIK, and CXL in the pediatric population.

Corneal Collagen Cross-Linking is a perfect resource for a wide range of clinicians and researchers, including general ophthalmologists, refractive surgeons, corneal specialists, pediatric ophthalmologists, and optometrists.

Farhad Hafezi, MD, PhD, completed his medical studies and earned his MD in Switzerland in 1992. From 1993 to 1994, he attended a 2-year course (now known as MSc Biology) in experimental medicine and biology at the ETH Zurich, followed by 3 years as a scientific postdoc in the Laboratory for Retinal Cell Biology in Zurich, Switzerland. Here, his research focused on molecular mechanisms of retinal degeneration using light-induced photoreceptor damage in transgenic mice as an experimental model. He identified the first gene that would completely protect from induced photoreceptor damage.    

In 1999, Dr. Hafezi met the inventor of CXL, Dr. Theo Seiler, who became chairman at the University of Zurich. Dr. Seiler introduced Dr. Hafezi to corneal research; Dr. Seiler’s introduction to the field was so influential that Dr. Hafezi completely changed his research focus. This change resulted in Dr. Hafezi becoming a refractive laser surgeon and one of the pioneers in the CXL method. Together with Dr. Seiler, he was instrumental in building a private institute in Zurich, Switzerland called IROC where the CXL technology was further clinically developed and the UV-X device was constructed and CE certified. His PhD from the Erasmus University of Rotterdam focused on the management of complications in refractive laser surgery.    

In 2010, Dr. Hafezi was appointed Chair and Professor of Ophthalmology of the University Eye Clinic of Geneva in Switzerland. In 2012, the Faculty of the Keck School of Medicine at the University of Southern California (USC) Los Angeles (Doheny Eye Institute) appointed him as Clinical Professor of Ophthalmology.    

Dr. Hafezi has published more than 100 peer-reviewed articles, book chapters, reviews, and letters, including articles in Nature Medicine and Nature Genetics. His work has been cited more than 3000 times. His total impact factor is 314 (ISI 2011) and his h factor is 31. He has received 14 national and international awards, including the highest national awards in Switzerland and Belgium and the 2014 ARVO Foundation/Pfizer Ophthalmics Carl Camras Translational Research Award. He is an Associate Editor of the Journal of Refractive Surgery and an Editorial Board Member of the Iranian Journal of Ophthalmology and The International Journal of Keratoconus and Ectatic Corneal Disease. Dr. Hafezi is fluent in German, English, French, Persian, and Polish. He is married to Nikki Hafezi and has 2 children, Leilah Alina and Lilian Malaya.    

J. Bradley Randleman, MD, is Professor of Ophthalmology at the Emory Eye Center and the Department of Ophthalmology at the Emory University School of Medicine. A widely respected cornea specialist, his areas of expertise include corneal and intraocular refractive surgical procedures, the management of corneal and external eye diseases, corneal transplantation, and cataract surgery. His primary research interests include preoperative refractive surgical screening; the avoidance, diagnosis, and management of refractive surgical complications; and diagnosis and management of corneal ectatic disorders.    

Dr. Randleman received his BA from Columbia College at Columbia University in New York City with a joint major in Biology and Psychology. He earned his MD from Texas Tech University School of Medicine in Lubbock, Texas, where he was elected to the Alpha Omega Alpha Medical Honor Society in his junior year. He then completed his ophthalmology residency training at Emory University, where he received the Outstanding Teaching Resident award while he served as Chief Resident in his final year. Dr. Randleman joined the Emory faculty and served as Assistant Residency Director for 2 years while also completing a fellowship in Cornea, External Disease and Refractive Surgery at Emory University. In 2004, he was awarded the prestigious Claes Dohlman Society Award, which is given annually to only one individual in the United States for academic and surgical excellence in cornea and refractive surgery training. He now serves as Director of the Emory Corneal Fellowship program. Since practicing and teaching at Emory, he has trained more than 80 physicians in cataract surgery, refractive surgery, and corneal transplantation.    

In 2007, Dr. Randleman was awarded the Secretariat Award from the American Academy of Ophthalmology (AAO) for special contributions to the field of ophthalmology. In 2010, he was presented the inaugural Binkhorst Young Ophthalmologist Award from the American Society of Cataract and Refractive Surgery (ASCRS).     

In 2011, Dr. Randleman was awarded the Kritzinger Memorial Award from the International Society of Refractive Surgery (ISRS). He was elected to the “135 Leading Ophthalmologists in America” listing by Becker’s Ambulatory Surgery Centers (ASC) Review. Dr. Randleman was also named as a “Top Ophthalmologist in America” by Castle Connolly Medical Ltd since 2010 and he is named as one of the “Best Doctors in America” by US News & World Reports.    

Dr. Randleman has served as Editor-in-Chief for the Journal of Refractive Surgery since 2010. He has authored more than 80 peer-reviewed publications in leading ophthalmology journals in addition to 15 book chapters on refractive surgery evaluation and management of complications.

Dedication  
Acknowledgments  
About the Editors  
Contributing Authors  
Foreword by George O. Waring IV, MD  
Introduction  

Section I Basic Principles of Corneal Biomechanics and Corneal Collagen Cross-Linking  
Chapter 1 Introduction to Corneal Biomechanics   William J. Dupps, Jr, MD, PhD 
Chapter 2 Fundamental Principles of Corneal Collagen Cross-Linking   Gregor Wollensak, MD 

Section II Etiology and Diagnosis of Corneal Ectatic Disorders  
Chapter 3 Evaluation and Diagnosis of Keratoconus and Pellucid Marginal Corneal Degeneration  Yaron S. Rabinowitz, MD 
Chapter 4 Evaluation and Diagnosis of Postoperative Corneal Ectasia   J. Bradley Randleman, MD and Maria A. Woodward, MD 

Section III Technical and Patient-Related Aspects of Corneal Collagen Cross-Linking  
Chapter 5 Patient Selection for Corneal Collagen Cross-Linking   R. Doyle Stulting, MD, PhD; George O. Waring IV, MD; Marcony R. Santhiago, MD, PhD; and  Luis F. De Castro, MD 
Chapter 6 The Standard Protocol and Its Parameters   Marianne O. Price, PhD and Francis W. Price, Jr, MD 
Chapter 7 Modifications for Thin Corneas   Farhad Hafezi, MD, PhD and Olivier Richoz, MD 
Chapter 8 Optimizing Treatment Parameters   Michael Mrochen, PhD and Silvia Schumacher, PhD 
Chapter 9 Intraoperative Corneal Changes During Corneal Collagen Cross-Linking   Paolo Vinciguerra, MD and Elena Albé, MD 

Section IV Corneal Collagen Cross-Linking for Corneal Ectatic Disorders  
Chapter 10 Corneal Collagen Cross-Linking for Progressive Keratoconus   Christine Wittig-Silva, MD and Markus Kohlhaas, MD 
Chapter 11 Corneal Collagen Cross-Linking for Postoperative Corneal Ectasia   Farhad Hafezi, MD, PhD and Nikolaos Mavrakanas, MD 
Chapter 12 Measuring the Efficacy of Corneal Collagen Cross-Linking Using Advanced Corneal Biomechanical Diagnostic Modalities   Renato Ambrósio, Jr, MD, PhD; Marcella Q. Salomão, MD; and Cynthia J. Roberts, PhD 
Chapter 13 Corneal Collagen Cross-Linking Complications and Their Management   J. Bradley Randleman, MD and Karolinne Maia Rocha, MD, PhD 

Section V Other Clinical Applications of Corneal Collagen Cross-Linking  
Chapter 14 Corneal Collagen Cross-Linking for Infectious Keratitis and Corneal Melts  Jes Mortensen, MD and Karim Makdoumi, MD, PhD 
Chapter 15 Corneal Collagen Cross-Linking for Corneal Stromal Edema  Niels Ehlers, MD, PhD and Jesper Hjortdal, MD, PhD 

Section VI Corneal Collagen Cross-Linking in Combination With Refractive Surgery Procedures  
Chapter 16 Corneal Collagen Cross-Linking in Combination With Surface Ablation  George Kymionis, MD, PhD and Georgios A. Kontadakis, MD, MSc 
Chapter 17 Corneal Collagen Cross-Linking in Combination With Intrastromal Corneal Ring Segments  David Touboul, MD; David Smadja, MD; and Joseph Colin, MD† 
Chapter 18 Corneal Collagen Cross-Linking in Combination With Phakic Intraocular Lenses Jose Güell, MD, PhD; Merce Morral, MD, PhD; Oscar Gris, MD, PhD; Daniel Elies, MD; and Felicidad Manero, MD 

Section VII Recent Developments in Corneal Collagen Cross-Linking  
Chapter 19 Corneal Collagen Cross-Linking Using Intrastromal Pockets Anastasios John Kanellopoulos, MD and Aylin Kiliç, MD 
Chapter 20 Corneal Collagen Cross-Linking: Epithelium-On Versus Epithelium-Off Treatments  Eberhard Spoerl, PhD 
Chapter 21 Pediatric Corneal Collagen Cross-Linking  Joseph Frucht-Pery, MD and Denise Wajnsztajn, MD 
Chapter 22 Hot Topics and Future Directions  J. Bradley Randleman, MD and Farhad Hafezi, MD, PhD 
Chapter 23 Summary of Commercially Available Corneal Collagen Cross-Linking Units  Frederik Raiskup, MD, PhD, FEBO 

Financial Disclosures 
Index  
†Joseph Colin, MD, now deceased, was an original author on this chapter.