A meta-analysis of studies comparing standard and transepithelial corneal cross-linking showed that both techniques are safe, but the standard procedure was more effective at decreasing maximum keratometry.
A systematic search through PubMed, the Cochrane Library and Embase identified 1,018 potentially relevant studies, of which only three met the inclusion criteria established by the authors. They included 244 eyes, with 111 eyes treated by standard CXL and 133 eyes treated by transepithelial CXL. The follow-up was from 12 to 24 months.
Maximum keratometry data favored standard CXL, with