{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T15:10:08Z","timestamp":1793373008300,"version":"4.5.0"},"reference-count":16,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2016,5,23]],"date-time":"2016-05-23T00:00:00Z","timestamp":1463961600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003761","name":"Universitair Medisch Centrum Utrecht","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003761","id-type":"DOI","asserted-by":"publisher"}]}],"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>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      Keratoconus is characterized by corneal ectasia and irregular astigmatism, which can lead to diminished vision and corneal scarring. Approximately 10\u201320% of patients with keratoconus eventually require a corneal transplant. Corneal cross\u2010linking (\n                      <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content>\n                      ) is a relatively new treatment that may help prevent the need for corneal transplantation. Here, we investigated whether the introduction of\n                      <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content>\n                      has reduced the number of corneal transplants performed annually.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Data regarding the transplantation procedures performed in patients under the age of 50\u00a0years were extracted from the Dutch National Organ Transplant Registry. The number of corneal transplants performed prior to (i.e. in 2005 through 2007) and following the introduction of\n                      <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content>\n                      (i.e. in 2012 through 2014) were compared. Furthermore, a trend analysis on annual keratoplasties over time was performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Approximately 25% fewer corneal transplants were performed in the 3\u2010year period following the introduction of\n                      <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content>\n                      compared to the 3\u2010year period prior to the introduction of\n                      <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content>\n                      (201 versus 269 transplants, respectively; p\n                      <jats:italic>\u00a0<\/jats:italic>\n                      =\n                      <jats:italic>\u00a0<\/jats:italic>\n                      0.005). Age, gender and visual acuity were similar between the patient groups in the two time periods. Trend analysis also demonstrated a significant decrease in the amount of corneal transplants (p\n                      <jats:italic>\u00a0<\/jats:italic>\n                      =\n                      <jats:italic>\u00a0<\/jats:italic>\n                      0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Significantly fewer corneal transplants were performed for treating keratoconus following the nationwide introduction of\n                      <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content>\n                      . This reduction suggests that corneal cross\u2010linking can significantly reduce the need for corneal transplantation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aos.13095","type":"journal-article","created":{"date-parts":[[2016,5,24]],"date-time":"2016-05-24T06:25:19Z","timestamp":1464071119000},"page":"675-678","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":155,"title":["Nationwide reduction in the number of corneal transplantations for keratoconus following the implementation of cross\u2010linking"],"prefix":"10.1111","volume":"94","author":[{"given":"Daniel A.","family":"Godefrooij","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Utrecht Cornea Research Group University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renze","family":"Gans","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Utrecht Cornea Research Group University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saskia M.","family":"Imhof","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Utrecht Cornea Research Group University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert P. L.","family":"Wisse","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Utrecht Cornea Research Group University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,5,23]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/APO.0b013e3182a4cf92"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2009.164228"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2011.07.057"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2009.10.021"},{"key":"e_1_2_5_6_1","unstructured":"CBS(2014):Centraal Bureau voor de Statistiek. \u2018Bevolking kerncijfers'. Available at:http:\/\/www.cbs.nl\/nl-NL\/menu\/themas\/bevolking\/cijfers\/default.htm. (Accessed on 29 Jul 2015)."},{"key":"e_1_2_5_7_1","unstructured":"College van Zorgverzekeringen(2015):Collageen crosslinking (CXL) bij pati\u00ebnten met keratoconus of keratectasie. Available at:https:\/\/www.zorginstituutnederland.nl\/binaries\/content\/documents\/zinl-www\/documenten\/publicaties\/rapporten-en-standpunten\/2014\/1406-standpunt-collageen-crosslinking-cxl-bij-keratoconus-en-keratectasie\/Standpunt+Collageen+crosslinking+-CXL-+bij+keratoconus+en+keratectasie.pdf. (Accessed on 2 Mar 2016)."},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.2013.278"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2010.07.030"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2010.196493"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/aos.12899"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6257(97)00119-7"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000000460"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e3180334f78"},{"key":"e_1_2_5_15_1","first-page":"720","article-title":"A randomized controlled trial of corneal collagen cross\u2010linking in progressive keratoconus: preliminary results","volume":"24","author":"Wittig\u2010Silva C","year":"2008","journal-title":"J Refract Surg"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2013.10.028"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(02)02220-1"}],"container-title":["Acta Ophthalmologica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faos.13095","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aos.13095","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T16:34:06Z","timestamp":1694882046000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aos.13095"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,5,23]]},"references-count":16,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2016,11]]}},"alternative-id":["10.1111\/aos.13095"],"URL":"https:\/\/doi.org\/10.1111\/aos.13095","archive":["Portico"],"relation":{},"ISSN":["1755-375X","1755-3768"],"issn-type":[{"value":"1755-375X","type":"print"},{"value":"1755-3768","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,5,23]]},"assertion":[{"value":"2015-09-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-03-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-05-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}