{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:29:00Z","timestamp":1781634540660,"version":"3.54.5"},"reference-count":37,"publisher":"Georg Thieme Verlag KG","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Monbl Augenheilkd"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Purpose To evaluate the efficacy of accelerated (9\u2009mW\/cm2, 10\u2009min) epithelium-off (epi-off) corneal crosslinking (A-CXL) in keratoconus (KC) patients &lt;\u200918 years of\n          age.<\/jats:p><jats:p>\n          Patients and Methods Our retrospective study included 41\u00a0eyes (25 male and 5 female patients, mean age 15.3\u2009\u00b1\u20091.2 years) who underwent A-CXL (9\u2009mW\/cm2, 10\u2009min) because of\n          progressive KC or critical KC at first presentation or asymmetrical finding in the partner eye. Outcome measures were best-corrected visual acuity (BCVA) and tomography readings (Pentacam\n          HR, Oculus, Wetzlar, Germany), evaluated 2 years, 1 year, 6 months preoperatively, prior to surgery (pre-CXL) and 6 weeks, 6 months, 1 year, 2 years, &gt;\u20092 years postoperatively (post-CXL).\n          The demarcation line was assessed by anterior segment optical coherence tomography (SS-1000 and CASIA 2, Tomey, Nagoya, Japan).<\/jats:p><jats:p>\n          Results Total deviation value increased statistically significantly 6 months pre-CXL to pre-CXL. Anterior steep, flat, and mean keratometry values showed a statistically significant\n          increase 6 weeks post-CXL (p\u2009&lt;\u20090.05), followed by a significant decrease until 2 years post-CXL for steep and mean keratometry. Kmax increased 6 weeks post-CXL without\n          statistical significance and decreased significantly even &gt;\u20092 years post-CXL (p\u2009&lt;\u20090.0001). Posterior keratometry as well as anterior and posterior astigmatism did not show any\n          significant changes post-CXL. Thinnest and apical pachymetry decreased significantly until 6 months post-CXL (p\u2009&lt;\u20090.05) and remained stable &gt;\u20092 years post-CXL (p\u2009&gt;\u20090.05). BCVA\n          decreased 6 weeks post-CXL but improved significantly &gt;\u20092 years post-CXL (p\u2009=\u20090.003). The demarcation line reached an average depth of 52.1%.<\/jats:p><jats:p>\n          Conclusions Epi-off A-CXL stabilizes KC progression in patients &lt;\u200918 years even &gt;\u20092 years postoperatively and leads to a deep demarcation line. A \u201cpseudoprogression\u201d is\n          observed up to the 6-week follow-up, which is not indicative of the long-term results.<\/jats:p>","DOI":"10.1055\/a-1933-3084","type":"journal-article","created":{"date-parts":[[2022,11,27]],"date-time":"2022-11-27T23:31:15Z","timestamp":1669591875000},"page":"1131-1142","source":"Crossref","is-referenced-by-count":14,"title":["Accelerated Corneal Crosslinking for Treatment of Keratoconus in Children and Adolescents under 18 Years of Age"],"prefix":"10.1055","volume":"240","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9181-8913","authenticated-orcid":false,"given":"Kassandra","family":"Xanthopoulou","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg\/Saar, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgia","family":"Milioti","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg\/Saar, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loay","family":"Daas","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg\/Saar, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian","family":"Munteanu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg\/Saar, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9701-8204","authenticated-orcid":false,"given":"Berthold","family":"Seitz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg\/Saar, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0423-3624","authenticated-orcid":false,"given":"Elias","family":"Flockerzi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg\/Saar, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,11,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2257","DOI":"10.1007\/s10792-017-0699-8","article-title":"Pediatric keratoconus: a review of the literature","volume":"38","author":"S Mukhtar","year":"2018","journal-title":"Int Ophthalmol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1016\/S0039-6257(97)00119-7","article-title":"Keratoconus","volume":"42","author":"Y S Rabinowitz","year":"1998","journal-title":"Surv 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Shetty","year":"2014","journal-title":"Biomed Res Int"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1016\/j.ajo.2009.10.021","article-title":"Long-term results of riboflavin ultraviolet a corneal collagen cross-linking for keratoconus in Italy: the Siena eye cross study","volume":"149","author":"A Caporossi","year":"2010","journal-title":"Am J Ophthalmol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1097\/ICO.0000000000001505","article-title":"Corneal collagen cross-linking with riboflavin and ultraviolet A light for pediatric keratoconus: ten-year\u00a0results","volume":"37","author":"C Mazzotta","year":"2018","journal-title":"Cornea"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1097\/ICO.0000000000001629","article-title":"Corneal cross-linking in pediatric patients: evaluating treated and untreated eyes-5-year follow-up results","volume":"37","author":"L Or","year":"2018","journal-title":"Cornea"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1097\/ICO.0000000000001102","article-title":"Corneal collagen cross-linking for keratoconus in pediatric patients-long-term results","volume":"36","author":"P Padmanabhan","year":"2017","journal-title":"Cornea"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1016\/j.ophtha.2008.09.048","article-title":"Refractive, topographic, tomographic, and aberrometric analysis of keratoconic eyes undergoing corneal cross-linking","volume":"116","author":"P Vinciguerra","year":"2009","journal-title":"Ophthalmology"}],"container-title":["Klinische Monatsbl\u00e4tter f\u00fcr Augenheilkunde"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1933-3084.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T22:34:49Z","timestamp":1698100489000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1933-3084"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,27]]},"references-count":37,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,10,23]]},"published-print":{"date-parts":[[2023,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1933-3084","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0023-2165","1439-3999"],"issn-type":[{"value":"0023-2165","type":"print"},{"value":"1439-3999","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,27]]}}}