Corneal Cross-Linking, Second Edition

Farhad Hafezi, MD; J. Bradley Randleman, MD
ISBN 10:
ISBN 13:
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8.50 x 11.00 x 0.40 inches

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Book Description

Corneal Cross-Linking, Second Edition represents an innovative approach to treating primary acquired and secondary induced ectatic disorders. In addition, corneal cross-linking (CXL) has promising applications as an alternative in the treatment of corneal infectious and non-infectious melting, as well as conditions such as Fuchs’ endothelial dystrophy.

The new and expanded Second Edition of Corneal Cross-Linking by Drs. Farhad Hafezi and J. Bradley Randleman will provide a concise yet comprehensive summary of the CXL process, including the basic science foundations, treatment protocols and outcomes, recognition and management of potential complications, and modification of standard protocol for special circumstances.

Given all the changes in this rapidly progressing field, many brief topics from the first edition have now grown into full chapters or sections.  These include expanded sections on alternative treatment protocols, corneal imaging and biomechanics, combing cross-linking with other refractive treatments, and a section devoted specifically to the most highly debated controversies in the field today.

With each chapter being fully updated plus including over twenty new chapters that covers the latest advances and future directions, Corneal Cross-Linking, Second Edition represents the cutting-edge of CXL research and clinical practice.  

“Since the publication of the first edition of this book in 2013, our knowledge of corneal cross-linking has again significantly increased, both scientifically and clinically. Today, concise recommendations (guidelines for cross-linking) help the clinician to select the patients, make decisions, and provide optimal treatment”
-Eberhard Spoerl, PhD and Theo Seiler, MD, PhD

More Information



About the Editors

About the Associate Editor

Contributing Authors

Foreword by Eberhard Spoerl, PhD, and Theo Seiler, MD, PhD


Section I          Basic Principles of Corneal Biomechanics and Corneal Cross-Linking

Chapter 1            History of Corneal Cross-Linking

                             Eberhard Spoerl, PhD, and Frederik Raiskup, MD, PhD, FEBO

Chapter 2            Introduction to Corneal Biomechanics

                             William J. Dupps Jr, MD, PhD

Chapter 3            Fundamental Principles of Corneal Cross-Linking

                             Gregor Wollensak, MD

Chapter 4            Riboflavin, Ultraviolet Light, and the Photochemical Reaction

                            Arie L. Marcovich, MD, PhD, and Alexander Brandis, PhD

Chapter 5            The Role of Oxygen in Corneal Cross-Linking

                             Olivier Richoz, MD, PhD; Sabine Kling, PhD; and Farhad Hafezi, MD, PhD

Chapter 6            Cross-Linking Initiated by Other Chromophores and by Multiphoton Excitation

                             Irene Kochevar, PhD

Chapter 7            Corneal Cross-Linking Safety Considerations

                             Christina Giannikas Starcic, MD; Leejee H. Suh, MD; and Stephen L. Trokel, MD

Chapter 8            Molecular Aspects of Corneal Cross-Linking

                            Rohit Shetty, FRCS, PhD; Natasha Kishore Pahuja, DOMS; and Harsha Nagaraja, MS, FCE

Chapter 9            Evaluation and Diagnosis of Keratoconus and Pellucid Marginal Degeneration

                             Marcony R. Santhiago, MD, PhD; Yaron S. Rabinowitz, MD; and J. Bradley Randleman, MD

Chapter 10          Evaluation and Diagnosis of Postoperative Corneal Ectasia

                             J. Bradley Randleman, MD; Maria A. Woodward, MD, MS; and Marcony R. Santhiago, MD, PhD

Section II        Corneal Cross-Linking for Corneal Ectasias

Chapter 11          Corneal Cross-Linking for Progressive Keratoconus

                            Tobias Koller, MD; Stefan Seiler, MD; and Theo Seiler, MD, PhD

Chapter 12          Corneal Cross-Linking for Postoperative Corneal Ectasia

                            David Tabibian, MD, and Farhad Hafezi, MD, PhD

Chapter 13          Corneal Cross-Linking for Pellucid Marginal Degeneration

                             Leopoldo Spadea, MD, and Roberto Secondi, MD

Section III      Corneal Cross-Linking Protocols and Complication Management

Chapter 14          The Standard Protocol and Its Parameters

                             Maria A. Woodward, MD, MS; David L. DeMill, MD; Francis W. Price Jr, MD; and

                             Marianne O. Price, PhD, MBA

Chapter 15          Corneal Cross-Linking Using Accelerated Protocols

                             George D. Kymionis, MD, PhD; Konstantinos I. Tsoulnaras, MD; and
                             Chrysanthi Koutsandrea, MD, PhD

Chapter 16          Epithelium-On Protocols: Conceptual/Basic Science

                             Eberhard Spoerl, PhD, and Suphi Taneri, MD

Chapter 17          Transepithelial Corneal Cross-Linking in Progressive Keratoconus

                             Frederik Raiskup, MD, PhD, FEBO

Chapter 18          Corneal Cross-Linking With Iontophoresis

                            Paolo Vinciguerra, MD; Riccardo Vinciguerra, MD; Fabrizio Camesasca, MD; Vito Romano, MD;
                             and Pietro Rosetta, MD

Chapter 19          Cross-Linking Protocols in Thin Corneas

                             Soosan Jacob, MS, FRCS, DNB, and Amar Agarwal, MS, FRCS, FRCOphth

Chapter 20          Pediatric Corneal Cross-Linking

                             Joseph Frucht-Pery, MD, and Denise Wajnsztajn, MD

Chapter 21          Corneal Cross-Linking Complications and Management

                             Karolinne Maia Rocha, MD, PhD; Koray Gümüş, MD, FEBOphth; and J. Bradley Randleman, MD

Section IV      Corneal Cross-Linking Imaging and Diagnostic Evaluations

Chapter 22          Measuring the Efficacy of Corneal Cross-Linking Using Advanced Corneal
                             Biomechanical Diagnostic Modalities

                             Renato Ambrósio Jr, MD, PhD; Marcella Q. Salomão, MD; and Cynthia Roberts, PhD

Chapter 23          Measuring the Efficacy of Cross-Linking: Clinical Metrics

                             J. Bradley Randleman, MD, and Praneetha Thulasi, MD

Chapter 24          Measuring Corneal Cross-Linking Efficacy: Biomechanical Measurement Approach

                             Giuliano Scarcelli; Seok Hyun Yun; and J. Bradley Randleman, MD

Chapter 25          Confocal Microscopy in Corneal Cross-Linking

                            Cosimo Mazzotta, MD, PhD, and Luigi Fontana, MD, PhD

Chapter 26          Optical Coherence Tomography Use in Corneal Cross-Linking

                             Sumitra S. Khandelwal, MD, and J. Bradley Randleman, MD

Chapter 27          Epithelial Remodeling After Corneal Cross-Linking

                             Karolinne Maia Rocha, MD, PhD, and Sudeep Dilip Sunthankar, MD

Section V        Cross-Linking Plus: Combination Procedures

Chapter 28          Corneal Cross-Linking in Combination With Transepithelial Phototherapeutic Keratectomy:
                             Cretan Protocol

                            George D. Kymionis, MD, PhD; Michael A. Grentzelos, MD;
                             and Chrysanthi Koutsandrea, MD, PhD

Chapter 29          Corneal Cross-Linking in Combination With Surface Ablation: Athens Protocol

                             Anastasios John Kanellopoulos, MD, and George Asimellis, PhD

Chapter 30          Corneal Cross-Linking in Combination With Intracorneal Ring Segment

                            Aylin Kılıç, MD, and David Touboul, MD

Chapter 31          Corneal Cross-Linking in Combination With Phakic Intraocular Lenses

                             Jose L. Güell, MD, PhD; Merce Morral, MD, PhD; Emilio J. Segovia, MD; Oscar Gris, MD, PhD;
                             Daniel Elies, MD; and Felicidad Manero, MD

Chapter 32          Corneal Cross-Linking: Combined Treatment Options

                             Efekan Coskunseven, MD, and Onurcan Sahin, MSc

Chapter 33          Corneal Cross-Linking as a Primary Refractive Procedure

                            George D. Kymionis, MD, PhD; Dimitra M. Portaliou, MD, PhD, FEBO; Michael A. Grentzelos, MD;
                             and Chrysanthi Koutsandrea, MD, PhD

Section VI      Cross-Linking for Infectious Keratitis: PACK-CXL

Chapter 34          PACK-CXL

                             Jes Mortensen, MD, and Karim Makdoumi, MD, PhD

Chapter 35          PACK-CXL for Viral Keratitis and Acanthamoeba Keratitis

                             Francis W. Price Jr, MD, and Marianne O. Price, PhD, MBA 

Section VII    Other Uses for Cross-Linking

Chapter 36          Corneal Cross-Linking for Corneal Stromal Edema

                             Niels Ehlers, MD, PhD, and Jesper Hjortdal, MD, PhD

Chapter 37          Sclera Cross-Linking

                             Brendan Geraghty, BEng(Hons), MSc, PhD, and Ahmed Elsheikh, BEng(Hon), MSc, PhD

Section VIII   Current Controversies and Perspectives

Chapter 38          Epithelium-On Treatments

                             In Favor

                             Steven E. Wilson, MD, and Andre A.M. Torricelli, MD, PhD


                             Aldo Caporossi, MD, PhD, FRCS; Antonio Villano, MD; Stefano Baiocchi, MD, PhD;
                             and Orsola Caporossi, MD, PhD

Chapter 39          Corneal Cross-Linking Can Impact Limbal Stem Cells

                             In Favor

                             Johnny E. Moore, FRCOphth, PhD; David Schiroli, PhD; and C.B. Tara Moore, PhD


                             Farhad Hafezi, MD, PhD, and Sabine Kling, PhD

Chapter 40          Performing Corneal Cross-Linking After Definitive Signs of
                             Ectasia Progression Are Detected

                             Renato Ambrósio Jr, MD, PhD; Rosane de Oliveira Corrêa, MD;
                             and Rozalia Litewski Beildeck, MD

Chapter 41          Prophylactic Cross-Linking Combined With LASIK

                             In Favor

                            Anastasios John Kanellopoulos, MD, and George Asimellis, PhD


                             Theo Seiler, MD, PhD

Chapter 42          Summary of Commercially Available Corneal Cross-Linking Units

                             George O. Waring IV, MD, FACS; Susannah L. Brown, MD;
                             and Frederik Raiskup, MD, PhD, FEBO

Financial Disclosures



“This book is a tour de force, an extremely valuable resource for anyone interested in and performing cornea cross-linking. It is a must-read for cornea specialists and a one-stop source of everything and anything related to cornea cross-linking.”
          -Charles C Lin, MD, Doody’s Book Review Service

About the Editors

Farhad Hafezi, MD, PhD, was born in 1967 and grew up in Fribourg, Switzerland. He studied medicine in Fribourg and Berne.Farhad Hafezi fluently speaks German (mother tongue), English, French, Polish, and Farsi. He is married to Nikki Hafezi and has three daughters, Leilah Alina (2008), Lilian Malaya (2010), and Lola Alexandra (2016).
Professor Hafezi’s clinical focus are the cornea and complication management after complicated refractive laser surgery. Being part of the team around Theo Seiler that translated cross-linking from experimental research into the clinical application, he was instrumental in implementing corneal cross-linking technology in ophthalmology.
From 2010 to 2014, Farhad Hafezi was Professor and Chairman of the Department of Ophthalmology of the Geneva University Hospitals, Geneva, Switzerland. Currently, Dr. Hafezi holds the following positions: Professor at the Faculty of Medicine, University of Geneva, Switzerland; Clinical Professor of Ophthalmology, Department of Ophthalmology USC Los Angeles, USA; Medical Director, The ELZA Institute, Zürich, Switzerland; Research Group Leader, Center for Applied Biotechnology and Molecular Medicine (CABMM), University of Zürich, Switzerland; and Visiting Professor, Faculty of Medicine, University of Wenzhou, China.
As of March 2017, Professor Hafezi has published more than 160 scientific articles, his scientific work has been cited more than 5700 times, his total impact factor is 510, and his h-index is 39.
He is an Associate Editor for the Journal of Refractive Surgery and is on the Editorial Boards of TVST, the International Journal of Keratoconus and Ectatic Corneal Disease, Eye and Vision and the Iranian Journal of Ophthalmology. Professor Hafezi is also a member of the Advisory Board of “Global ONE,” the educational network of the American Academy of Ophthalmology (AAO).
Professor Hafezi has received 22 national and international awards and distinctions, both for his scientific work and for the development of new technologies (innovation awards). Awards include, among others, the ARVO Foundation/Carl Camras Translational Research Award (USA) 2014, as well as the highest distinctions in ophthalmology from Switzerland and Belgium.
In 2014, Professor Hafezi was voted by peers onto the “PowerList,” a list of the 100 most influential international personalities in ophthalmology. In April 2016, he was again voted onto the PowerList.
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J. Bradley Randleman, MD, is Professor of Ophthalmology at the Keck School of Medicine of USC and Director of the Cornea & Refractive Surgery Service at the USC Roski Eye Institute in Los Angeles, California. A widely respected cornea specialist, his areas of expertise include: corneal and intraocular refractive surgical procedures including LASIK and premium laser-assisted cataract and IOL surgery, complicated cataract surgery, and the management of corneal ectatic disorders. His primary research focuses on identification and management of corneal ectatic diseases including keratoconus and postoperative ectasia after LASIK, and the avoidance, diagnosis, and management of refractive surgical complications.
Dr. Randleman received his BA degree from Columbia College at Columbia University in New York City, his M.D. degree 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, followed by his Ophthalmology residency at Emory University in Atlanta, Georgia. Dr. Randleman joined the Emory faculty and served as Assistant Residency Director for two years while also completing a fellowship in Cornea/External Disease, and Refractive Surgery at Emory University. He served as Director of the Emory Corneal Fellowship program until taking over as Director of the Cornea Service.
Dr. Randleman has been awarded the Claus Dohlman Fellow Award, the inaugural Binkhorst Young Ophthalmologist Award from the American Society of Cataract and Refractive Surgery, the Kritzinger Memorial Award, the Inaugural ISRS Recognition Award, the Secretariat Award, Achievement Award, and Senior Achievement Award from the American Academy of Ophthalmology.
Dr. Randleman has served as Editor-in-Chief for the Journal of Refractive Surgery since 2011. He has authored more than 120 peer-reviewed publications in leading ophthalmology journals in addition to 30 book chapters on refractive surgery evaluation, corneal cross-linking, and management of complications with IOLs, and has authored two additional textbooks, Refractive Surgery: An Interactive Case-Based Approach (2014), and Intraocular Lens Surgery: Selection, Complications, and Complex Cases.