{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T07:18:50Z","timestamp":1785568730360,"version":"3.56.0"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2016,4,29]],"date-time":"2016-04-29T00:00:00Z","timestamp":1461888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To analyse the long\u2010term efficacy of corneal cross\u2010linking (<jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content>) in children with keratoconus and to describe criteria for the detection of pseudoprogression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Evaluation of retrospectively collected corneal topography (Placido system) and tomography (Scheimpflug system) results after <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> in children (age 18 or younger). Twenty\u2010five patients (33 eyes) were included. Follow\u2010up was assessed after 1, 2, 3 and 4\u00a0years. Progression was defined as an increase in maximal keratometry (Kmax) of at least one dioptre (D) in 1\u00a0year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For the entire group, mean Kmax prior to <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> was 55.3\u00a0\u00b1\u00a07.3D and decreased significantly (p\u00a0=\u00a00.00001) after 1\u00a0year to 53.4\u00a0\u00b1\u00a07.4D. In 23 patients, the progression could be halted. Five cases of presumed progression were identified. One case showed marked steepening in Kmax 4\u00a0years after <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content>, but the topographic parameters were unchanged. The tomography was repeated and showed that Kmax was stable. Two cases with limbal vernal keratoconjunctivitis (<jats:styled-content style=\"fixed-case\">VKC<\/jats:styled-content>) worsened both in corneal tomography and topography. After resolution of the limbal inflammation, the Kmax values returned to the values before the inflammation. We found two cases of true progression both of which had advanced keratoconus prior to <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> with a preoperative Kmax of 64.4, respectively, 75.1D.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results confirm that <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> is effective in stabilizing keratoconus in children. True progression after <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> could only be verified in two of 33 eyes in a follow\u2010up period of 37.5\u00a0months (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\u00a0\u00b1\u00a010\u00a0months). Two different measuring methods can help to detect diagnostic discrepancies and prevent false conclusions. Moreover, limbal vernal changes can cause transient pseudoprogression, reversible upon sufficient treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.13060","type":"journal-article","created":{"date-parts":[[2016,4,30]],"date-time":"2016-04-30T17:01:17Z","timestamp":1462035677000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Analysis of pseudoprogression after corneal cross\u2010linking in children with progressive keratoconus"],"prefix":"10.1111","volume":"94","author":[{"given":"Kaspar","family":"Schuerch","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Inselspital University Hospital Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Tappeiner","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Inselspital University Hospital Bern 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