The Dynamic Safety for Cross-Linking in Thin Corneas With Extra Protection Under a Contact Lens.

In the article “Contact Lens-Assisted Collagen CrossInking (CACXL): A New Technique for Cross-Linking Thin Corneas” by Jacob et al.,1 the authors proposed a contact lens for extra protection of corneal collagen cross-linking (CXL) in thin corneas (range: 350 to 498 μm; mean: 377 μm). In their study, the treated corneas are protected by the contact lens and riboflavin (B2). I intend to provide a detailed analysis regarding the safety issues in the above described two-layer system. Furthermore, I will demonstrate that contact lenses are not the only safety solution for thin corneas, where low doses may be applied for thinner corneas. The safety dose (with a contact lens) may be expressed as