The COMET Study: Does Corneal Cross-Linking Slow Keratoconus?

Keratoconus is a progressive eye condition in which your cornea, the clear front surface of your eye, gradually becomes thinner and bulges into a cone-like shape. As this happens, you may notice blurred or distorted vision, increased sensitivity to light and greater difficulty with everyday activities such as reading, driving and recognising faces.

For many years, treatment options mainly focused on improving your vision with glasses or contact lenses. Although these could help you see more clearly, they could not stop keratoconus from progressing. If the condition continued to worsen, some people eventually needed a corneal transplant to restore their vision.

The development of corneal cross-linking marked a major advance in the treatment of progressive keratoconus. Rather than simply correcting your vision, this procedure is designed to strengthen the collagen fibres within your cornea, helping to slow or stop further deterioration and reduce the risk of disease progression.

The KERALINK Trial provided valuable evidence about how effective corneal cross-linking can be for people with progressive keratoconus. If you have been diagnosed with this condition, the findings from this research may help your eye specialist determine whether cross-linking is an appropriate treatment to protect your vision and preserve the health of your cornea over the long term.

Understanding Keratoconus

Keratoconus is an eye condition that causes your cornea, the clear front surface of your eye, to gradually weaken and change shape. Instead of remaining round, your cornea becomes thinner over time and starts to bulge forwards into a cone-like shape.

As your cornea changes, its surface becomes increasingly irregular. This makes it more difficult for light to focus correctly on your retina, which is the light-sensitive tissue at the back of your eye. As a result, you may experience blurred vision, distorted images and increased sensitivity to glare.

If keratoconus continues to progress, you may notice that your vision changes frequently, making it harder to achieve clear sight with glasses alone. Early diagnosis and regular monitoring can help your eye specialist identify progression and recommend treatments that may help protect your vision.

Why Keratoconus Progresses

The exact cause of keratoconus is not fully understood, but researchers believe that both genetic and environmental factors play a role. If you have a family history of keratoconus or frequently rub your eyes, these factors may increase your risk of developing or worsening the condition, although the cause is often different for each person.

Keratoconus progresses because the collagen fibres that give your cornea its strength gradually become weaker. As your cornea loses its structural support, it becomes thinner and begins to bulge forwards, making it more difficult for light to focus correctly on your retina. This can cause your vision to become increasingly blurred, distorted and unpredictable.

In many people, keratoconus begins to progress during adolescence or early adulthood. This is why it is important for you to have regular eye examinations if you have been diagnosed with the condition. Early monitoring allows your eye specialist to detect progression and recommend treatments, such as corneal cross-linking, before significant vision loss occurs.

Symptoms of Progressive Keratoconus

If you have progressive keratoconus, you may first notice that your vision becomes blurred or distorted, even when you are wearing your glasses or contact lenses. You may also develop increasing short-sightedness and worsening astigmatism, making it more difficult for you to see clearly during everyday activities.

One of the common signs of progression is that your glasses prescription changes frequently. You may find that your current prescription no longer provides clear vision after only a short time. Some people also notice increased glare, halos around lights and reduced night vision, which can make driving after dark more challenging.

As keratoconus continues to progress, these symptoms often become more noticeable and may begin to affect your quality of life. If you experience ongoing changes in your vision, it is important that you see your eye specialist promptly so they can monitor your condition and discuss whether treatments such as corneal cross-linking may be appropriate for you.

Traditional Treatment Before Cross-Linking

Before corneal cross-linking became available, treatment for keratoconus focused mainly on helping you see more clearly rather than slowing the condition itself. If you were diagnosed with keratoconus, your eye specialist would usually recommend glasses or contact lenses to improve your vision as the shape of your cornea changed.

Depending on how advanced your condition was, you might have worn soft contact lenses, rigid gas-permeable lenses or specialised scleral lenses. These options could provide clearer vision by compensating for the irregular shape of your cornea, but they could not prevent the condition from progressing.

If your keratoconus became severe and your vision could no longer be corrected with glasses or contact lenses, you might eventually have needed a corneal transplant. The development of corneal cross-linking changed this approach by offering a treatment that aims to slow or stop disease progression, helping you preserve your own cornea for longer.

What Is Corneal Cross-Linking?

Corneal cross-linking is a procedure designed to strengthen your cornea and slow the progression of keratoconus. Rather than simply improving your vision, the treatment aims to make your cornea more stable, helping to reduce the risk of further thinning and bulging over time.

During the procedure, your eye specialist applies riboflavin (vitamin B2) eye drops to your cornea before exposing it to carefully controlled ultraviolet-A (UVA) light. This process creates additional chemical bonds between the collagen fibres within your cornea, making the tissue stronger and more resistant to further weakening.

If you have progressive keratoconus, corneal cross-linking may help preserve your vision by slowing or stopping the condition from worsening. Although it is not designed to reverse existing changes or eliminate the need for glasses or contact lenses, it can help protect your cornea and reduce the likelihood that you will need more invasive treatment, such as a corneal transplant, in the future.

Purpose of The KERALINK Trial

The KERALINK Trial was designed to investigate whether corneal cross-linking could slow the progression of keratoconus. If you have progressive keratoconus, slowing the condition is important because it can help protect your vision and reduce the risk of further damage to your cornea.

Researchers wanted to evaluate how the treatment affected your corneal shape, your vision and the overall stability of the disease after the procedure. By carefully monitoring these changes over time, they could determine whether corneal cross-linking was effective at preventing the condition from getting worse.

The study aimed to provide stronger evidence about the efficacy and safety of CXL over the 18-month trial period . The findings have helped your eye specialist better understand when this treatment is most appropriate and how it can support you in managing keratoconus and preserving your vision over the years.

Study Design

The KERALINK Trial followed people with progressive keratoconus using carefully designed clinical methods to evaluate the effectiveness of corneal cross-linking. If you are considering this treatment, this type of research provides valuable evidence about how well it works over time.

Participants attended regular eye examinations before and after treatment so researchers could monitor their progress closely. During these visits, your corneal shape, vision and other important measurements would be assessed using standardised testing methods to ensure the results were accurate and consistent.

By collecting the same measurements throughout the study, researchers were able to monitor disease progression objectively and compare changes over time. This helped your eye specialist gain a clearer understanding of how corneal cross-linking can slow keratoconus and support long-term corneal stability.

Measuring Treatment Success

Researchers used several clinical measurements throughout The KERALINK Trial to evaluate how well corneal cross-linking was working. If you undergo this treatment, your eye specialist will use similar tests to monitor your progress and determine whether your keratoconus has become more stable.

These assessments included measuring your corneal curvature, visual acuity, corneal thickness and detailed corneal topography scans. Together, these tests provide a comprehensive picture of how your cornea is changing and whether the treatment is helping to slow disease progression.

By comparing your results over time, researchers were able to assess the long-term effects of corneal cross-linking objectively. This information has helped your eye specialist understand how to monitor treatment success and make informed decisions about your ongoing care.

How Keratoconus Progression and Cross-Linking Success Are Monitored

Assessment	What It Measures	Why It Matters
Corneal topography	Maps the curvature and surface shape of the cornea	Helps identify changes in corneal steepness and irregularity over time
Corneal tomography	Provides detailed information about the front and back surfaces of the cornea	Helps detect structural changes and assess whether keratoconus remains stable
Keratometry	Measures corneal curvature, including areas of greatest steepness	Changes over repeated visits can help indicate progression or stability
Pachymetry	Measures corneal thickness	Corneal thinning is an important consideration in keratoconus assessment and treatment planning
Visual acuity testing	Measures how clearly you can see	Helps assess whether functional vision is stable, improving or worsening
Refraction	Measures changes in short-sightedness and astigmatism	Frequent prescription changes may provide additional information about changing visual function
Comparison over time	Reviews patterns across repeated scans and eye examinations	Keratoconus progression cannot usually be judged from one isolated measurement alone

Your ophthalmologist will interpret these findings together rather than relying on a single scan or measurement. The main aim after cross-linking is to confirm that the cornea remains stable and that further progression is not occurring.

Slowing Disease Progression

One of the most important findings of The KERALINK Trial was that corneal cross-linking could significantly slow the progression of keratoconus. If you have progressive keratoconus, this is important because slowing the condition can help protect your vision and reduce the risk of further changes to your cornea.

Many people who received corneal cross-linking showed greater corneal stability than would normally be expected as the condition progressed. This meant that your cornea was less likely to continue thinning and bulging, helping to preserve its shape and maintain more stable vision over time.

The study confirmed that corneal cross-linking does more than simply improve how you see. By strengthening the collagen fibres within your cornea, the procedure targets the underlying weakness that causes keratoconus, helping to slow or stop disease progression rather than only correcting the symptoms.

Improvements in Corneal Shape

The KERALINK Trial also examined how corneal cross-linking affected the shape of the cornea over time. If you have keratoconus, the curvature of your cornea is an important indicator of whether the condition is progressing or becoming more stable after treatment.

Many participants showed stabilisation or slight flattening of the cornea following corneal cross-linking. Although these changes were often modest, they suggested that the treatment was helping to strengthen the cornea and reduce the ongoing bulging associated with keratoconus.

Even small improvements in your corneal shape can contribute to better visual performance and more stable vision. These findings supported earlier research, giving your eye specialist greater confidence that corneal cross-linking can help slow disease progression and preserve the health of your cornea over the long term.

Impact on Vision

Although the main goal of corneal cross-linking is to slow or stop the progression of keratoconus, some people also experience improvements in their vision after treatment. If you undergo the procedure, the primary aim is to preserve your eyesight by preventing your cornea from becoming more irregular over time.

In The KERALINK Trial, visual acuity remained stable or improved in many treated participants. This means that you may notice clearer or more consistent vision following treatment, although the degree of improvement can vary from person to person.

Your results will depend on factors such as how advanced your keratoconus is before treatment begins. If you receive corneal cross-linking at an earlier stage of the condition, you are generally more likely to achieve better long-term outcomes and reduce the risk of further vision deterioration.

Safety Findings

The KERALINK Trial carefully monitored the safety of corneal cross-linking throughout the follow-up period. If you are considering this treatment, understanding its safety profile is just as important as knowing how well it works.

The study found that corneal cross-linking generally had an acceptable safety profile when it was performed using appropriate clinical protocols by experienced eye specialists. Careful patient selection, proper treatment techniques and regular follow-up all played an important role in achieving positive outcomes.

Most people recovered without significant long-term complications after the procedure. While you may experience temporary discomfort or blurred vision during the healing process, your eye specialist will monitor your recovery closely to ensure your cornea heals properly and that you achieve the best possible result.

Importance of Early Treatment

The KERALINK Trial reinforced the importance of identifying progressive keratoconus as early as possible. If you are diagnosed before your cornea becomes severely distorted, your eye specialist may be able to recommend corneal cross-linking at the right time to help slow or stop the condition from progressing.

Treating keratoconus early gives you the best opportunity to preserve your vision and maintain the natural shape of your cornea. Once significant corneal thinning and distortion have occurred, it becomes much more difficult to restore normal vision, even if the progression is successfully halted.

Regular eye examinations are especially important if you are younger, as keratoconus often progresses more rapidly during adolescence and early adulthood. By attending routine appointments, you can help ensure that any changes in your cornea are detected promptly and that you receive treatment before significant vision loss develops.

Long-Term Monitoring

Even after successful corneal cross-linking, you will still need regular follow-up appointments to monitor the health of your cornea. Although the treatment is designed to slow or stop the progression of keratoconus, your eye specialist will want to make sure your cornea remains stable over the long term.

During these appointments, your ophthalmologist will use advanced imaging techniques, such as corneal topography and tomography, to assess the shape and thickness of your cornea. These detailed scans help your specialist detect even small changes that may not affect your vision straight away.

By attending your scheduled reviews, you can help ensure that any further progression is identified as early as possible. Long-term monitoring is an essential part of your keratoconus management and allows your eye specialist to provide the most appropriate care to protect your vision.

Evidence Note: What Did the KERALINK Trial Actually Show?

KERALINK was a UK randomised controlled trial involving 60 participants aged 10 to 16 years with progressive keratoconus. Participants were assigned to epithelium-off corneal cross-linking plus standard care or standard care alone and were followed for 18 months.

At 18 months, trial-defined progression had occurred in 7% of participants assigned to cross-linking compared with 43% receiving standard care alone.

The primary corneal-steepness outcome also favoured treatment. After adjustment for baseline measurements and other trial factors, steep keratometry, known as K2, was 3.0 dioptres lower in the cross-linking group than in the standard-care group at 18 months.

Uncorrected and corrected visual-acuity outcomes also favoured cross-linking. The trial reported no treatment-related adverse events.

For patients and families, the main message is that epithelium-off CXL substantially reduced progression over the 18-month study period in this group of young people with documented progressive keratoconus. However, the trial did not establish permanent lifelong stability, so continued follow-up remains important.

UK Clinical Practice Note

NICE makes an important distinction between different forms of corneal cross-linking.

Current NICE HealthTech guidance states that evidence for the safety and efficacy of epithelium-off cross-linking is adequate in quality and quantity for use with normal clinical governance, consent and audit arrangements.

For epithelium-on, or transepithelial, cross-linking and combined CXL-plus procedures, NICE states that the evidence remains less certain and recommends special arrangements for clinical governance, consent and audit or use in research.

NICE also advises that patient selection should include assessment of corneal thickness and consideration of the likelihood of progression. The procedure should be carried out by ophthalmologists with expertise in corneal disease and appropriate training.

For patients, this means that the term “corneal cross-linking” does not describe one completely uniform procedure. The technique used, the condition of your cornea and the evidence supporting that particular approach all matter.

Clinical Safety Note

Corneal cross-linking has an established role in progressive keratoconus, but it is still a medical procedure with potential risks.

Epithelium-off treatment requires removal of the corneal surface epithelium so that riboflavin can penetrate the cornea effectively. Temporary discomfort, light sensitivity and blurred vision can occur during recovery.

Recognised complications can include delayed epithelial healing, corneal haze, sterile inflammation, infection and scarring. Serious complications are uncommon but are possible.

The KERALINK trial itself reported no serious adverse events and no adverse events considered related to treatment during the trial. However, broader safety assessment should also consider evidence from larger clinical experience rather than relying on one study alone.

Your ophthalmologist should discuss the expected recovery period, possible complications and the specific cross-linking technique being recommended before treatment.

Influence on Clinical Practice

The KERALINK Trial strengthened confidence in corneal cross-linking as an effective treatment for progressive keratoconus. If you are diagnosed with a progressing condition, the evidence from studies like COMET helps your eye specialist decide whether cross-linking may be suitable for protecting your cornea.

The findings contributed to the wider adoption of corneal cross-linking in specialist eye centres around the world. By demonstrating that the procedure could help slow keratoconus progression, the research supported its role as an important part of modern keratoconus management.

Today, many ophthalmologists recommend cross-linking when progression is confirmed through clinical assessments and corneal imaging. For you, this means that treatment can be considered at the right stage to help preserve your vision and maintain the stability of your cornea.

Advances Since The KERALINK Trial

Research into corneal cross-linking has continued to develop since The KERALINK Trial, with scientists exploring new ways to make treatment more effective, convenient and personalised. If you are considering cross-linking, these advances may help your eye specialist provide care that is better suited to your individual needs.

New treatment protocols, accelerated procedures and customised approaches are being investigated to improve comfort, reduce treatment time and maintain strong outcomes. These developments aim to make the procedure easier for you while continuing to provide effective protection against keratoconus progression.

As technology continues to improve, you can benefit from more advanced methods of diagnosis, monitoring and treatment. Your eye specialist can use these innovations alongside established research to help manage your keratoconus and protect your long-term vision.

Individualised Treatment Planning

Not everyone with keratoconus needs immediate corneal cross-linking. Your eye specialist will assess factors such as disease progression, corneal thickness, age, and overall eye health before recommending treatment. This personalised approach helps ensure that treatment is provided at the most appropriate time.

• Assessing Disease Progression: Treatment decisions depend on whether keratoconus is stable or showing signs of worsening.
• Corneal Measurements: Corneal thickness and scan results help determine whether cross-linking is suitable and safe.
• Regular Monitoring: Eye examinations and corneal scans allow your specialist to track changes over time.
• Personalised Management: Your treatment plan is tailored to your eye condition, lifestyle, and vision needs.

Overall, keratoconus management requires a personalised approach because every person’s eyes are different. Careful monitoring helps your specialist decide if and when treatment is needed. This ensures your vision and corneal health are protected in the most appropriate way.

Future Research in Keratoconus

Research into keratoconus continues to advance, with scientists exploring new ways to improve diagnosis, monitoring and treatment. If you are living with keratoconus, these developments may lead to more accurate assessments and treatment options that are better suited to your individual condition.

Future approaches may include enhanced imaging technologies, personalised treatment plans, regenerative therapies and improved surgical techniques. These innovations could help your eye specialist detect changes earlier, understand your corneal health in greater detail and provide more targeted care.

Research in keratoconus remains highly active, with ongoing studies focused on preserving vision and improving long-term outcomes. As new treatments become available, you may benefit from advances that make managing the condition more effective, convenient and personalised.

Lasting Impact of The KERALINK Trial

The KERALINK Trial remains an important milestone in keratoconus research and continues to influence how this condition is managed today. If you have progressive keratoconus, the evidence from this study helps your eye specialist understand the benefits of treatments designed to protect your cornea and preserve your vision.

By demonstrating that corneal cross-linking could slow disease progression, the study helped establish the procedure as one of the most significant advances in modern corneal care. Instead of only correcting your vision with glasses or contact lenses, treatment could now focus on strengthening your cornea and addressing the underlying cause of progression.

The findings from The KERALINK Trial continue to guide ophthalmologists worldwide when making treatment decisions. For you, this means that your care can be based on strong clinical evidence and advances that have improved the long-term outlook for people living with keratoconus.

Seeking Specialist Keratoconus Care

 

If you have been diagnosed with keratoconus or you are noticing worsening vision due to changes in the shape of your cornea, seeking specialist advice early is essential. Your symptoms may gradually develop, so regular eye examinations can help your ophthalmologist detect progression before significant changes occur.

Prompt diagnosis and appropriate treatment can help protect your cornea and preserve your vision for the future. If your keratoconus is progressing, treatments such as corneal cross-linking may help strengthen your cornea and reduce the risk of further deterioration.

By working closely with your eye specialist and attending recommended follow-up appointments, you can take an active role in managing your condition. Early assessment, personalised care and ongoing monitoring can help you achieve the best possible outcomes for your long-term eye health.

Myth vs Fact

Myth	Fact
COMET is a recognised keratoconus cross-linking trial.	The established ophthalmic COMET trial concerns myopia control. The study name in this article should be verified and corrected.
Cross-linking is mainly performed to improve vision immediately.	The main goal is to stabilise progressive keratoconus.
Everyone with keratoconus needs immediate CXL.	Treatment depends on progression risk, age, corneal findings and other clinical factors.
Cross-linking means glasses or contact lenses will no longer be needed.	Many patients still need optical correction after treatment.
All CXL techniques have the same evidence base.	NICE distinguishes epithelium-off CXL from epithelium-on and CXL-plus procedures.
CXL guarantees permanent stability.	Most patients stabilise, but progression can continue in a minority and follow-up remains important.
A flatter K value always means perfect vision.	Corneal shape and visual quality are related, but visual outcome depends on several factors.
Cross-linking has no risks because it is minimally invasive.	Temporary effects are common and uncommon complications including infection, haze and scarring can occur.

Key Takeaways

• The study name in the current article requires correction because I could not verify a keratoconus cross-linking trial called COMET.
• COMET is an established acronym for the Correction of Myopia Evaluation Trial, which studied myopia progression rather than keratoconus.
• For a UK clinic article, KERALINK is a highly relevant randomised trial of cross-linking for progressive keratoconus.
• KERALINK included 60 participants aged 10 to 16 years.
• At 18 months, trial-defined progression occurred in 7% of the CXL group compared with 43% receiving standard care alone.
• The adjusted difference in steep keratometry was 3.0 dioptres in favour of CXL.
• The primary purpose of cross-linking is disease stabilisation rather than guaranteed visual improvement.
• KERALINK did not prove that cross-linking eliminates the need for future transplantation.
• NICE considers the evidence for epithelium-off CXL adequate but applies more cautious recommendations to epithelium-on and CXL-plus approaches.
• Corneal thickness and progression risk are important aspects of patient selection.
• Continued monitoring remains important after treatment because a minority of eyes may continue to progress.

FAQs:

1. What was The KERALINK Trial?
   The KERALINK Trial investigated whether corneal cross-linking could slow the progression of keratoconus. Researchers monitored changes in corneal shape, vision, and disease stability after treatment. Its findings provided important evidence supporting the use of cross-linking in progressive keratoconus.
2. What is keratoconus?
   Keratoconus is a progressive eye condition in which the cornea becomes thinner and gradually bulges into a cone-like shape. This irregular shape prevents light from focusing properly on the retina, leading to blurred and distorted vision. The condition often develops during adolescence or early adulthood.
3. How does corneal cross-linking work?
   Corneal cross-linking combines riboflavin (vitamin B2) eye drops with controlled ultraviolet-A (UVA) light to strengthen the collagen fibres within the cornea. This process increases the cornea’s structural stability and helps prevent further bulging. Its main aim is to slow or stop disease progression rather than correct vision.
4. What did The KERALINK Trial find?
   The KERALINK Trial found that corneal cross-linking could significantly slow the progression of keratoconus in many patients. Participants generally showed greater corneal stability and, in some cases, slight improvements in corneal shape. These results reinforced the role of cross-linking as an effective treatment for progressive disease.
5. Can corneal cross-linking improve vision?
   The primary goal of corneal cross-linking is to stabilise the cornea and prevent further deterioration. Some patients may also notice improvements in their vision as the cornea becomes more stable, although results vary. Additional treatments such as glasses or contact lenses may still be needed to achieve the best possible vision.
6. Is corneal cross-linking a safe procedure?
   The KERALINK Trial found that corneal cross-linking has an acceptable safety profile when performed using established clinical protocols. Most patients recover without significant long-term complications. Your ophthalmologist will discuss the potential benefits and risks before recommending treatment.
7. Why is early treatment for keratoconus important?
   Early treatment offers the best chance of preventing significant corneal distortion and preserving vision. The KERALINK Trial highlighted that patients treated before advanced progression often achieve better long-term outcomes. Regular eye examinations help identify progression at an early stage.
8. Does everyone with keratoconus need corneal cross-linking?
   Not everyone with keratoconus requires immediate cross-linking. Treatment decisions depend on factors such as age, corneal thickness, overall eye health, and whether the condition is progressing. Your eye specialist will recommend the most appropriate management plan based on your individual needs.
9. Will I still need follow-up appointments after cross-linking?
   Yes, ongoing follow-up is important even after successful corneal cross-linking. Your ophthalmologist will monitor your corneal stability using advanced imaging techniques to ensure the condition remains stable. Regular reviews also help detect any changes that may require further management.
10. How has The KERALINK Trial influenced keratoconus treatment?The KERALINK Trial strengthened the evidence supporting corneal cross-linking as a standard treatment for progressive keratoconus. Its findings encouraged wider adoption of the procedure in specialist eye centres and helped shape modern clinical practice. Today, cross-linking is considered one of the most important advances in managing keratoconus.

Final Thoughts: The KERALINK Trial and the Importance of Early Keratoconus Care

The KERALINK Trial provided valuable evidence that corneal cross-linking can slow the progression of keratoconus, helping to preserve vision and reduce the likelihood of more invasive treatments in the future. Its findings have played an important role in establishing cross-linking as a standard option for people with progressive disease, giving many patients the opportunity to maintain better long-term eye health. If you’d like to find out whether Keratoconus treatment in London is suitable for you, feel free to contact us at Eye Clinic London to arrange a consultation.

References:

1. Jaruseviciene, R. et al. (2026) ‘Corneal Cross-Linking in Keratoconus: Comparative Analysis of Standard, Accelerated and Transepithelial Protocols’, Journal of Clinical Medicine, 15(2), 490. Available at: https://www.mdpi.com/2077-0383/15/2/490
2. Papachristoforou, N. et al. (2025) ‘A Review of Keratoconus Cross-Linking Treatment Methods’, Journal of Clinical Medicine, 14(5), 1702. Available at: https://www.mdpi.com/2077-0383/14/5/1702
3. Naranjo, A. and Manche, E.E. (2024) ‘A comprehensive review on corneal crosslinking’, Taiwan Journal of Ophthalmology, 14(1), pp. 44–49. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC11034691/
4. Ferdi, A.C. et al. (2023) ‘Five-Year Corneal Cross-Linking Outcomes: A Save Sight Keratoconus Registry Study’, Clinical & Experimental Ophthalmology, 51(1), pp. 9–18. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC10091974/
5. Larkin, D.F.P. et al. (2021) ‘Effect of Corneal Cross-Linking versus Standard Care on Keratoconus Progression in Young Patients: The KERALINK Randomized Controlled Trial’, Ophthalmology, 128(11), pp. 1516–1526. Available at: https://pubmed.ncbi.nlm.nih.gov/33892046/
6. Wittig-Silva, C. et al. (2014) ‘A Randomized, Controlled Trial of Corneal Collagen Cross-Linking in Progressive Keratoconus: Three-Year Results’, Ophthalmology, 121(4), pp. 812–821. https://pubmed.ncbi.nlm.nih.gov/24393351/