Accelerated CXL: present and future

Conventional and accelerated CXL protocols have demonstrated medium- to long-term improvement in visual acuity and topographic and aberrometric parameters; however, the results are often variable and unpredictable due to the uneven biologic response of collagen to photodynamic reaction. Early diagnosis of corneal ectasia is mandatory, especially in pediatric patients who generally demonstrate faster progression. Today, the CXL therapeutic window allows treatment in about 20 minutes, with a good balance between efficacy and tolerability for the patient, optimizing the time of surgery without affecting treatment efficacy.