{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T04:49:26Z","timestamp":1780548566175,"version":"3.54.1"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,10,24]],"date-time":"2016-10-24T00:00:00Z","timestamp":1477267200000},"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":[[2017,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To evaluate possible risk factors leading to sterile corneal infiltrates following corneal collagen cross\u2010linking (<jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 588 eyes of 459 patients treated with Epi\u2010off (<jats:italic>n<\/jats:italic>\u00a0=\u00a0461) or Epi\u2010on (<jats:italic>n<\/jats:italic>\u00a0=\u00a0127) <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> were retrospectively evaluated. Risk factors, including preoperative blepharitis and vernal conjunctivitis, the postoperative use of topical non\u2010steroidal anti\u2010inflammatory drugs (<jats:styled-content style=\"fixed-case\">NSAID<\/jats:styled-content>s), as well as Kmax and pachymetry measurements, were assessed. <jats:italic>In vivo<\/jats:italic> confocal microscopy (<jats:styled-content style=\"fixed-case\">IVCM<\/jats:styled-content>) and anterior segment optical coherence tomography (<jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">OCT<\/jats:styled-content>) analyses were performed in patients with sterile infiltrates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sterile infiltrates developed in 19 cases (3.2%). No patients in the Epi\u2010on group developed sterile infiltrates. The evaluation of acceleration of the <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> procedure as a risk factor revealed no specific difference in the incidence of infiltrates among four different Epi\u2010off groups (3\u00a0mW\/cm<jats:sup>2<\/jats:sup>\u201330\u00a0min, 9\u00a0mW\/cm<jats:sup>2<\/jats:sup>\u201310\u00a0min, 18\u00a0mW\/cm<jats:sup>2<\/jats:sup>\u20135\u00a0min, 30\u00a0mW\/cm<jats:sup>2<\/jats:sup>\u20134\u00a0min procedures; p\u00a0&gt;\u00a00.05, all). Blepharitis, vernal conjunctivitis, Kmax and pachymetry were not identified as risk factors (p\u00a0&gt;\u00a00.05). Postoperative use of <jats:styled-content style=\"fixed-case\">NSAID<\/jats:styled-content>s was a significant contributor (p\u00a0=\u00a00.007), and it increased the chance of sterile infiltrates 4.09 times (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.463\u201311.428). <jats:styled-content style=\"fixed-case\"><jats:italic>In vivo<\/jats:italic> confocal microscopy (IVCM)<\/jats:styled-content> showed non\u2010specific inflammation with dendritic cells at the epithelium and at Bowman's layer. In <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">OCT<\/jats:styled-content>, a hyper\u2010reflective band at the level of the anterior stroma to a depth of 100\u2013140\u00a0<jats:italic>\u03bc<\/jats:italic>m was observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The evaluation of the risk factors such as blepharitis, the use of <jats:styled-content style=\"fixed-case\">NSAID<\/jats:styled-content>s, vernal conjunctivitis, the duration of <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> procedure and amount of light intensity showed that epithelial damage is possibly the common pathway in the pathogenesis, as no sterile infiltrates in Epi\u2010on <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> occurred, and the postoperative use of <jats:styled-content style=\"fixed-case\">NSAID<\/jats:styled-content>s increased the risk of developing sterile infiltrates about four times.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.13218","type":"journal-article","created":{"date-parts":[[2016,10,24]],"date-time":"2016-10-24T09:25:12Z","timestamp":1477301112000},"page":"199-204","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Sterile corneal infiltrates after corneal collagen cross\u2010linking: evaluation of risk factors"],"prefix":"10.1111","volume":"95","author":[{"given":"Eren","family":"\u00c7erman","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Marmara University School of Medicine Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deniz \u00d6zarslan","family":"\u00d6zcan","sequence":"additional","affiliation":[{"name":"Ak\u00e7akale State Hospital \u015eanl\u0131urfa Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebru","family":"Toker","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Marmara University School of Medicine Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,10,24]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"crossref","first-page":"154","DOI":"10.3928\/1081-597X-20030301-11","article-title":"Bilateral marginal sterile infiltrates and diffuse lamellar keratitis after laser in\u00a0situ keratomileusis","volume":"19","author":"Ambrosio R","year":"2003","journal-title":"J Refract Surg"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2008.11.050"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004397-199103120-00014"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clae.2012.06.002"},{"key":"e_1_2_5_6_1","first-page":"85","article-title":"Involvement of corneal epithelial cells in the Th17 response in an in\u00a0vitro bacterial inflammation model","volume":"19","author":"Arranz\u2010Valsero I","year":"2013","journal-title":"Mol Vis"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003226-200011000-00003"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2011.12.017"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.3928\/1081597X-20110812-02"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0b013e318240c7ff"},{"key":"e_1_2_5_11_1","doi-asserted-by":"crossref","first-page":"55","DOI":"10.3928\/1081-597X-19900101-12","article-title":"Delayed sterile keratitis following radial keratotomy requiring corneal transplantation for visual rehabilitation","volume":"6","author":"Geggel HS","year":"1990","journal-title":"Refract Corneal Surg"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e318226da53"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e3181a06c31"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.02-0838"},{"key":"e_1_2_5_15_1","first-page":"61","article-title":"Sterile peripheral keratitis following laser in\u00a0situ keratomileusis","volume":"15","author":"Haw WW","year":"1999","journal-title":"J Refract Surg"},{"key":"e_1_2_5_16_1","first-page":"748","article-title":"Sterile corneal infiltrates. 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