{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T06:04:18Z","timestamp":1792821858371,"version":"4.5.0"},"reference-count":28,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T00:00:00Z","timestamp":1664323200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100021262","name":"Light for Sight Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100021262","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004543","name":"China Scholarship Council","doi-asserted-by":"publisher","award":["202008330323"],"award-info":[{"award-number":["202008330323"]}],"id":[{"id":"10.13039\/501100004543","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Experimental Eye Research"],"published-print":{"date-parts":[[2022,11]]},"DOI":"10.1016\/j.exer.2022.109267","type":"journal-article","created":{"date-parts":[[2022,9,24]],"date-time":"2022-09-24T20:05:11Z","timestamp":1664049911000},"page":"109267","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":7,"special_numbering":"C","title":["Repeated application of riboflavin during corneal cross-linking does not improve the biomechanical stiffening effect ex vivo"],"prefix":"10.1016","volume":"224","author":[{"given":"Hormoz","family":"Abdshahzadeh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reyhaneh","family":"Abrishamchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Enes","family":"Aydemir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikki","family":"Hafezi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Hillen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio A.","family":"Torres-Netto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan-Ji","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8935-4558","authenticated-orcid":false,"given":"Farhad","family":"Hafezi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.exer.2022.109267_bib1","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1097\/ICO.0000000000001707","article-title":"Corneal cross-linking: current USA status: report from the cornea society","volume":"37","author":"Belin","year":"2018","journal-title":"Cornea"},{"key":"10.1016\/j.exer.2022.109267_bib2","doi-asserted-by":"crossref","first-page":"798","DOI":"10.3928\/1081597X-20160920-03","article-title":"Comparison of corneal riboflavin gradients using dextran and HPMC solutions","volume":"32","author":"Ehmke","year":"2016","journal-title":"J. Refract. Surg."},{"key":"10.1016\/j.exer.2022.109267_bib3","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1097\/ICO.0000000000000408","article-title":"Global consensus on keratoconus and ectatic diseases","volume":"34","author":"Gomes","year":"2015","journal-title":"Cornea"},{"key":"10.1016\/j.exer.2022.109267_bib4","doi-asserted-by":"crossref","first-page":"78","DOI":"10.3928\/1081597X-20201123-02","article-title":"Corneal cross-linking at the slit lamp","volume":"37","author":"Hafezi","year":"2021","journal-title":"J. Refract. Surg."},{"key":"10.1016\/j.exer.2022.109267_bib5","first-page":"e10","article-title":"Corneal cross-linking for keratoglobus using individualized fluence","volume":"1","author":"Hafezi","year":"2021","journal-title":"J Refr Surg Case Rep"},{"key":"10.1016\/j.exer.2022.109267_bib6","doi-asserted-by":"crossref","first-page":"6581","DOI":"10.1167\/iovs.15-17426","article-title":"Establishing corneal cross-linking with riboflavin and UV-A in the mouse cornea in vivo: biomechanical analysis","volume":"56","author":"Hammer","year":"2015","journal-title":"Invest. Ophthalmol. Vis. Sci."},{"key":"10.1016\/j.exer.2022.109267_bib7","doi-asserted-by":"crossref","first-page":"2881","DOI":"10.1167\/iovs.13-13748","article-title":"Corneal biomechanical properties at different corneal cross-linking (CXL) irradiances","volume":"55","author":"Hammer","year":"2014","journal-title":"Invest. Ophthalmol. Vis. Sci."},{"key":"10.1016\/j.exer.2022.109267_bib8","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1016\/j.ophtha.2013.01.012","article-title":"Corneal collagen cross-linking with riboflavin and ultraviolet a irradiation for keratoconus: long-term results","volume":"120","author":"Hashemi","year":"2013","journal-title":"Ophthalmology"},{"key":"10.1016\/j.exer.2022.109267_bib9","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1016\/j.ophtha.2017.03.052","article-title":"United States multicenter clinical trial of corneal collagen crosslinking for keratoconus treatment","volume":"124","author":"Hersh","year":"2017","journal-title":"Ophthalmology"},{"key":"10.1016\/j.exer.2022.109267_bib10","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/0002-9394(86)90817-2","article-title":"A 48-year clinical and epidemiologic study of keratoconus","volume":"101","author":"Kennedy","year":"1986","journal-title":"Am. J. Ophthalmol."},{"key":"10.1016\/j.exer.2022.109267_bib11","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1167\/tvst.6.1.7","article-title":"Corneal cross-linking with riboflavin and UV-A in the mouse cornea in vivo: morphological, biochemical, and physiological analysis","volume":"6","author":"Kling","year":"2017","journal-title":"Translational vision science & technology"},{"key":"10.1016\/j.exer.2022.109267_bib12","doi-asserted-by":"crossref","first-page":"840","DOI":"10.3928\/1081597X-20151111-08","article-title":"Increased biomechanical efficacy of corneal cross-linking in thin corneas due to higher oxygen availability","volume":"31","author":"Kling","year":"2015","journal-title":"J. Refract. Surg."},{"key":"10.1016\/j.exer.2022.109267_bib13","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-021-96775-w","article-title":"Collagen V insufficiency in a mouse model for Ehlers Danlos-syndrome affects viscoelastic biomechanical properties explaining thin and brittle corneas","volume":"11","author":"Kling","year":"2021","journal-title":"Sci. Rep."},{"key":"10.1016\/j.exer.2022.109267_bib14","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1167\/iovs.61.6.29","article-title":"Quasi-static optical coherence elastography to characterize human corneal biomechanical properties","volume":"61","author":"Kling","year":"2020","journal-title":"Invest. Ophthalmol. Vis. Sci."},{"key":"10.1016\/j.exer.2022.109267_bib15","series-title":"Java Applets for Power and Sample Size","author":"Lenth","year":"2006"},{"key":"10.1016\/j.exer.2022.109267_bib16","doi-asserted-by":"crossref","DOI":"10.1155\/2016\/7472542","article-title":"Novel technique of transepithelial corneal cross-linking using iontophoresis in progressive keratoconus","volume":"2016","author":"Lombardo","year":"2016","journal-title":"J Ophthalmol"},{"key":"10.1016\/j.exer.2022.109267_bib17","doi-asserted-by":"crossref","first-page":"438","DOI":"10.3928\/1081597X-20180515-02","article-title":"Enhanced-fluence pulsed-light iontophoresis corneal cross-linking: 1-year morphological and clinical results","volume":"34","author":"Mazzotta","year":"2018","journal-title":"J. Refract. Surg."},{"issue":"2","key":"10.1016\/j.exer.2022.109267_bib18","doi-asserted-by":"crossref","first-page":"137","DOI":"10.5005\/jp-journals-10025-1171","article-title":"Pachymetry-based accelerated cross-linking: the \u201cM nomogram\u201d for standardized treatment of all-thickness progressive ectatic corneas","volume":"7","author":"Mazzotta","year":"2019","journal-title":"Int. J. Keratoconus Ectatic Corneal Dis."},{"key":"10.1016\/j.exer.2022.109267_bib19","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1016\/j.jcrs.2007.12.039","article-title":"Collagen crosslinking with riboflavin and ultraviolet-A light in keratoconus: long-term results","volume":"34","author":"Raiskup-Wolf","year":"2008","journal-title":"J. Cataract Refract. Surg."},{"key":"10.1016\/j.exer.2022.109267_bib20","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/j.survophthal.2015.04.002","article-title":"Corneal cross-linking","volume":"60","author":"Randleman","year":"2015","journal-title":"Surv. Ophthalmol."},{"key":"10.1016\/j.exer.2022.109267_bib21","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1167\/tvst.2.7.6","article-title":"The biomechanical effect of corneal collagen cross-linking (CXL) with riboflavin and UV-A is oxygen dependent","volume":"2","author":"Richoz","year":"2013","journal-title":"Translational vision science & technology"},{"key":"10.1016\/j.exer.2022.109267_bib22","doi-asserted-by":"crossref","first-page":"281","DOI":"10.3928\/1081597X-20161219-03","article-title":"CXL at the slit lamp: No clinically relevant changes in corneal riboflavin distribution during upright UV irradiation","volume":"33","author":"Salmon","year":"2017","journal-title":"J. Refract. Surg."},{"key":"10.1016\/j.exer.2022.109267_bib23","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1167\/iovs.12-11387","article-title":"Brillouin microscopy of collagen crosslinking: noncontact depth-dependent analysis of corneal elastic modulus","volume":"54","author":"Scarcelli","year":"2013","journal-title":"Invest. Ophthalmol. Vis. Sci."},{"key":"10.1016\/j.exer.2022.109267_bib24","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1136\/bjophthalmol-2017-311391","article-title":"Prevalence of keratoconus in paediatric patients in Riyadh, Saudi Arabia","volume":"102","author":"Torres Netto","year":"2018","journal-title":"Br. J. Ophthalmol."},{"key":"10.1016\/j.exer.2022.109267_bib25","doi-asserted-by":"crossref","first-page":"768","DOI":"10.3928\/1081597X-20180830-01","article-title":"Oxygen diffusion may limit the biomechanical effectiveness of iontophoresis-assisted transepithelial corneal cross-linking","volume":"34","author":"Torres-Netto","year":"2018","journal-title":"J. Refract. Surg."},{"key":"10.1016\/j.exer.2022.109267_bib26","doi-asserted-by":"crossref","first-page":"49","DOI":"10.3928\/1081597X-20191211-01","article-title":"Similar biomechanical cross-linking effect after SMILE and PRK in human corneas in an ex vivo model for postoperative ectasia","volume":"36","author":"Torres-Netto","year":"2020","journal-title":"J. Refract. Surg."},{"key":"10.1016\/j.exer.2022.109267_bib27","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1016\/S0886-3350(03)00407-3","article-title":"Stress-strain measurements of human and porcine corneas after riboflavin\u2013ultraviolet-A-induced cross-linking","volume":"29","author":"Wollensak","year":"2003","journal-title":"J. Cataract Refract. Surg."},{"key":"10.1016\/j.exer.2022.109267_bib28","doi-asserted-by":"crossref","first-page":"721","DOI":"10.3928\/1081597X-20191004-01","article-title":"Depth-dependent reduction of biomechanical efficacy of contact lens-assisted corneal cross-linking analyzed by Brillouin microscopy","volume":"35","author":"Zhang","year":"2019","journal-title":"J. Refract. Surg."}],"container-title":["Experimental Eye Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0014483522003475?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0014483522003475?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T05:34:25Z","timestamp":1762148065000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0014483522003475"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11]]},"references-count":28,"alternative-id":["S0014483522003475"],"URL":"https:\/\/doi.org\/10.1016\/j.exer.2022.109267","relation":{},"ISSN":["0014-4835"],"issn-type":[{"value":"0014-4835","type":"print"}],"subject":[],"published":{"date-parts":[[2022,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Repeated application of riboflavin during corneal cross-linking does not improve the biomechanical stiffening effect ex vivo","name":"articletitle","label":"Article Title"},{"value":"Experimental Eye Research","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.exer.2022.109267","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2022 The Authors. Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"109267"}}