No author has a financial or proprietary interest in any material or method mentioned.

Ultraviolet corneal collagen cross-linking (CXL) has been shown to possibly delay, halt, or even reverse disease progression in keratoconus. Understanding of keratoconic progression in untreated eyes, however, is still incomplete and is hampered by the varying definitions and metrics used to evaluate corneal changes. As a result, the CXL literature varies widely in criteria for progression and parameters for successful outcomes. To date, there have been few long-term, well-controlled clinical trials supporting the efficacy of CXL to prevent progression in keratoconus. Review of our data on keratoconus suggests the course of corneal change is difficult to predict and that many keratoconic eyes appear stable once the eyes begin to exhibit frank changes in corneal curvature typical of keratoconus. Better-defined metrics for progression in keratoconus are needed. Larger, long-term randomized clinical trials may more clearly establish the efficacy and safety of CXL in the management of keratoconus and determine which patients are the best candidates for this procedure.

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* BACKGROUND AND OBJECTIVE: A retrospective study was undertaken to establish predictive clinical features for final visual outcome and ocular survival for patients who have sustained traumatic retinal detachments (RDs). * PATIENTS AND METHODS: The authors reviewed 191 cases of RD following open- or closedglobe trauma. The clinical features that were analyzed included the initial visual acuity, the location of the wound, the mechanism of injury (blunt, sharp, or projectile), and the number of quadrants of RD. * RESULTS: The significant predictive factors for good visual outcome (1/200 or better) included an initial visual acuity of hand motions or better, wounds located anterior to the equator, closed-globe injuries, sharp injury in open globes, and three or fewer quadrants of RD. The factors that predicted enucleation included an initial visual acuity of light perception or no light perception, wounds located posterior to the equator, and four quadrants of RD. * CONCLUSION: The significant predictive factors for final visual outcome in patients witli traumatic RD were the initial visual acuity, the location of the wound, the mechanism of injury, and the number of quadrants of RD. [Ophthalmic Surg Lasers 1998;29:48-54.]