{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T19:12:11Z","timestamp":1789499531603,"version":"build-2803163510"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T00:00:00Z","timestamp":1718668800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T00:00:00Z","timestamp":1718668800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003509","name":"\u00d6rebro University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003509","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Graefes Arch Clin Exp Ophthalmol"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>To evaluate progression of keratoconus in patients where CXL treatment was interrupted due to insufficient swelling of the cornea.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A retrospective review was conducted of all patients with keratoconus diagnosis who underwent CXL at the Department of Ophthalmology, \u00d6rebro University Hospital (US\u00d6) during the years 2010\u20132017. In total 377 eyes of 280 patients were screened for inclusion. In 17 eyes (15 patients), the treatment was interrupted due to insufficient swelling of the cornea. Patient journals were reviewed and keratometry examinations were analysed for long-term progression.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Eleven eyes (nine patients) were included in the study. Five eyes showed no signs of progression after the interrupted CXL treatment. In one eye progression continued, however, first after a period of a number of years, indicating a delayed course of clinical progression.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This study indicates that debridement of the corneal epithelium and riboflavin administration without intense UVA radiation may slow or arrest the progression of keratoconus, likely due to photosensitisation from ambient light.<\/jats:p>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00417-024-06505-x","type":"journal-article","created":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T10:02:06Z","timestamp":1718704926000},"page":"3643-3648","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The impact of interrupted corneal collagen crosslinking (CXL) treatment"],"prefix":"10.1007","volume":"262","author":[{"given":"Marit","family":"Tholvsen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1552-3819","authenticated-orcid":false,"given":"Karim","family":"Makdoumi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,18]]},"reference":[{"key":"6505_CR1","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1038\/eye.2013.278","volume":"28","author":"AE Davidson","year":"2014","unstructured":"Davidson AE, Hayes S, Hardcastle AJ, Tuft SJ (2014) The pathogenesis of keratoconus. Eye (Lond) 28:189\u2013195","journal-title":"Eye (Lond)"},{"key":"6505_CR2","doi-asserted-by":"publisher","first-page":"1363","DOI":"10.1007\/s00417-018-3966-0","volume":"256","author":"SK Subasinghe","year":"2018","unstructured":"Subasinghe SK, Ogbuehi KC, Dias GJ (2018) Current perspectives on corneal collagen crosslinking (CXL). Graefes Arch Clin Exp Ophthalmol 256:1363\u20131384","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"6505_CR3","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1016\/S0002-9394(02)02220-1","volume":"135","author":"G Wollensak","year":"2003","unstructured":"Wollensak G, Spoerl E, Seiler T (2003) Riboflavin\/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus. Am J Ophthalmol 135:620\u2013627","journal-title":"Am J Ophthalmol"},{"key":"6505_CR4","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1167\/iovs.09-3738","volume":"51","author":"AS McCall","year":"2010","unstructured":"McCall AS, Kraft S, Edelhauser HF, Kidder GW, Lundquist RR, Bradshaw HE, Dedeic Z, Dionne MJ, Clement EM, Conrad GW (2010) Mechanisms of corneal tissue cross-linking in response to treatment with topical riboflavin and long-wavelength ultraviolet radiation (UVA). Invest Ophthalmol Vis Sci 51:129\u2013138","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"6505_CR5","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/j.jcrs.2005.12.092","volume":"32","author":"M Kohlhaas","year":"2006","unstructured":"Kohlhaas M, Spoerl E, Schilde T, Unger G, Wittig C, Pillunat LE (2006) Biomechanical evidence of the distribution of cross-links in corneas treated with riboflavin and ultraviolet A light. J Cataract Refract Surg 32:279\u2013283","journal-title":"J Cataract Refract Surg"},{"key":"6505_CR6","doi-asserted-by":"publisher","first-page":"1519","DOI":"10.1136\/bjo.2010.196493","volume":"95","author":"DPS O'Brart","year":"2011","unstructured":"O\u2019Brart DPS, Chan E, Samaras K, Patel P, Shah SP (2011) A randomised, prospective study to investigate the efficacy of riboflavin\/ultraviolet A (370 nm) corneal collagen cross-linkage to halt the progression of keratoconus. Br J Ophthalmol 95:1519\u20131524","journal-title":"Br J Ophthalmol"},{"key":"6505_CR7","doi-asserted-by":"publisher","first-page":"812","DOI":"10.1016\/j.ophtha.2013.10.028","volume":"121","author":"C Wittig-Silva","year":"2014","unstructured":"Wittig-Silva C, Chan E, Islam FMA, Wu T, Whiting M, Snibson GR (2014) A randomized, controlled trial of corneal collagen cross-linking in progressive keratoconus: Three-year results. Ophthalmology 121:812\u2013821","journal-title":"Ophthalmology"},{"key":"6505_CR8","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1007\/s10792-015-0054-x","volume":"35","author":"N Sharma","year":"2015","unstructured":"Sharma N, Suri K, Sehra SV, Titiyal JS, Sinha R, Tandon R, Vajpayee RB (2015) Collagen cross-linking in keratoconus in Asian eyes: visual, refractive and confocal microscopy outcomes in a prospective randomized controlled trial. Int Ophthalmol 35:827\u2013832","journal-title":"Int Ophthalmol"},{"key":"6505_CR9","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/j.jcrs.2010.07.030","volume":"37","author":"PS Hersh","year":"2011","unstructured":"Hersh PS, Greenstein SA, Fry KL (2011) Corneal collagen crosslinking for keratoconus and corneal ectasia: One-year results. J Cataract Refract Surg 37:149\u2013160","journal-title":"J Cataract Refract Surg"},{"key":"6505_CR10","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1016\/j.joco.2017.07.003","volume":"29","author":"M Mohammadpour","year":"2017","unstructured":"Mohammadpour M, Masoumi A, Mirghorbani M, Shahraki K, Hashemi H (2017) Updates on corneal collagen cross-linking: Indications, techniques and clinical outcomes. J Curr Ophthalmol 29:235\u2013247","journal-title":"J Curr Ophthalmol"},{"key":"6505_CR11","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.jcrs.2014.09.033","volume":"41","author":"F Raiskup","year":"2015","unstructured":"Raiskup F, Theuring A, Pillunat LE, Spoerl E (2015) Corneal collagen crosslinking with riboflavin and ultraviolet-A light in progressive keratoconus: ten-year results. J Cataract Refract Surg 41:41\u201346","journal-title":"J Cataract Refract Surg"},{"key":"6505_CR12","doi-asserted-by":"publisher","first-page":"262","DOI":"10.2174\/1874364101711010262","volume":"11","author":"JH Woo","year":"2017","unstructured":"Woo JH, Iyer JV, Lim L, Hla MH, Mehta JS, Chan CM, Tan DT (2017) Conventional Versus Accelerated Collagen Cross-Linking for Keratoconus: A Comparison of Visual, Refractive, Topographic and Biomechanical Outcomes. Open Ophthalmol J 11:262\u2013272","journal-title":"Open Ophthalmol J"},{"key":"6505_CR13","doi-asserted-by":"publisher","first-page":"e8758","DOI":"10.1097\/MD.0000000000008758","volume":"96","author":"A Cantemir","year":"2017","unstructured":"Cantemir A, Alexa AI, Galan BG, Anton N, Ciuntu RE, Danielescu C, Chiselita D, Costin D (2017) Outcomes of iontophoretic corneal collagen crosslinking in keratoconic eyes with very thin corneas. Medicine 96:e8758","journal-title":"Medicine"},{"key":"6505_CR14","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1159\/000357979","volume":"232","author":"N Sorkin","year":"2014","unstructured":"Sorkin N, Varssano D (2014) Corneal collagen crosslinking: a systematic review. Ophthalmologica 232:10\u201327","journal-title":"Ophthalmologica"},{"key":"6505_CR15","doi-asserted-by":"publisher","first-page":"8","DOI":"10.4103\/ijo.IJO_1403_18","volume":"67","author":"R Deshmukh","year":"2019","unstructured":"Deshmukh R, Hafezi F, Kymionis GD, Kling S, Shah R, Padmanabhan P, Sachdev MS (2019) Current concepts in crosslinking thin corneas. Indian J Ophthalmol 67:8\u201315","journal-title":"Indian J Ophthalmol"},{"key":"6505_CR16","doi-asserted-by":"publisher","first-page":"128","DOI":"10.3928\/1081597X-20161206-01","volume":"33","author":"S Kling","year":"2017","unstructured":"Kling S, Hafezi F (2017) An algorithm to predict the biomechanical stiffening effect in corneal cross-linking. J Refract Surg 33:128\u2013136","journal-title":"J Refract Surg"},{"key":"6505_CR17","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1016\/j.ajo.2020.12.011","volume":"224","author":"F Hafezi","year":"2021","unstructured":"Hafezi F, Kling S, Gilardoni F, Hafezi N, Hillen M, Abrishamchi R, Gomes JAP, Mazzotta C, Randleman JB, Torres-Netto EA (2021) Individualized corneal cross-linking with riboflavin and UV-A in ultrathin corneas: The Sub400 protocol. Am J Ophthalmol 224:133\u2013142","journal-title":"Am J Ophthalmol"},{"key":"6505_CR18","doi-asserted-by":"publisher","first-page":"686630","DOI":"10.3389\/fphar.2021.686630","volume":"12","author":"D Wu","year":"2021","unstructured":"Wu D, Lim DK, Lim BXH, Wong N, Hafezi F, Manotosh R, Lim CHL (2021) Corneal cross-linking: The evolution of treatment for corneal diseases. Front Pharmacol 12:686630","journal-title":"Front Pharmacol"},{"key":"6505_CR19","doi-asserted-by":"publisher","first-page":"657","DOI":"10.2147\/OPTH.S101386","volume":"11","author":"V Galvis","year":"2017","unstructured":"Galvis V, Tello A, Ortiz AI, Escaf LC (2017) Patient selection for corneal collagen cross-linking: an updated review. Clin Ophthalmol 11:657\u2013668","journal-title":"Clin Ophthalmol"},{"key":"6505_CR20","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1016\/S0886-3350(98)80284-8","volume":"24","author":"JH Krumeich","year":"1998","unstructured":"Krumeich JH, Daniel J, Kn\u00fclle A (1998) Live-epikeratophakia for keratoconus. J Cataract Refract Surg 24:456\u2013546","journal-title":"J Cataract Refract Surg"},{"key":"6505_CR21","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1186\/s40662-015-0025-3","volume":"2","author":"X Chen","year":"2015","unstructured":"Chen X, Stojanovic A, Eidet JR, Utheim TP (2015) Corneal collagen cross-linking (CXL) in thin corneas. Eye Vis (Lond) 2:15","journal-title":"Eye Vis (Lond)"}],"container-title":["Graefe's Archive for Clinical and Experimental Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00417-024-06505-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00417-024-06505-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00417-024-06505-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,23]],"date-time":"2024-11-23T01:04:40Z","timestamp":1732323880000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00417-024-06505-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,18]]},"references-count":21,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["6505"],"URL":"https:\/\/doi.org\/10.1007\/s00417-024-06505-x","relation":{},"ISSN":["0721-832X","1435-702X"],"issn-type":[{"value":"0721-832X","type":"print"},{"value":"1435-702X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,18]]},"assertion":[{"value":"24 September 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 March 2024","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 May 2024","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 June 2024","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the (place name of institution and\/or national research committee) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the regional ethical board, Uppsala, Sweden (ref. 218\/372). Informed consent was obtained from all individual participants included in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Both authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers\u2019 bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}