{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T22:00:07Z","timestamp":1783720807923,"version":"3.55.0"},"reference-count":35,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,11,7]],"date-time":"2017-11-07T00:00:00Z","timestamp":1510012800000},"content-version":"vor","delay-in-days":6,"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":[[2017,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To compare 3\u2010year iontophoretic corneal collagen cross\u2010linking (I\u2010<jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content>) outcomes with epithelium\u2010off corneal collagen cross\u2010linking (epi\u2010off <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content>) for early stage of progressive keratoconus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eighty eyes of 80 patients with early progressive keratoconus treated by I\u2010<jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u00a0=\u00a040) or epi\u2010off <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u00a0=\u00a040) were included in this study. Uncorrected (<jats:styled-content style=\"fixed-case\">UDVA<\/jats:styled-content>) and corrected (<jats:styled-content style=\"fixed-case\">CDVA<\/jats:styled-content>) distance visual acuities, refraction, corneal topography and pachymetry were assessed at baseline and at 1, 3, 6, 12, 24 and 36\u00a0months of follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Visual acuity (VA) showed a significant improvement (p\u00a0&lt;\u00a00.05) at the end of follow\u2010up in both groups. In the I\u2010<jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> group, the <jats:styled-content style=\"fixed-case\">UDVA<\/jats:styled-content> showed a rapid recovery after 3\u00a0months (p\u00a0=\u00a00.04). There was a statistically significant different trend in <jats:styled-content style=\"fixed-case\">CDVA<\/jats:styled-content> between groups with a more favourable outcome for the standard <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> group (p\u00a0&lt;\u00a00.01). The cylinder improved beginning with 3\u00a0months after <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> in both groups. Maximum keratometry showed a significant reduction by 0.9 dioptres (D) in the I\u2010<jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> group and by 1.2 D in the epi\u2010off <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> group after 36\u00a0months (p\u00a0=\u00a00.283). Pachymetry values decreased at 3\u00a0months while a statistically significant increase occurred in both groups at 24\u00a0months. Progression occurred to one patient (2.5%) in I\u2010<jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> group. Adverse effects occurred to eight eyes (20%) in the epi\u2010off <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Iontophoretic corneal collagen cross\u2010linking (I\u2010CXL) is non\u2010inferior to epi\u2010off <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> for stopping the progression of keratoconus in its early stages with a higher degree of safety for the patients and a faster recovery of VA.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.13538","type":"journal-article","created":{"date-parts":[[2017,11,7]],"date-time":"2017-11-07T07:15:15Z","timestamp":1510038915000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Iontophoretic collagen cross\u2010linking versus epithelium\u2010off collagen cross\u2010linking for early stage of progressive keratoconus \u2013 3\u00a0years follow\u2010up study"],"prefix":"10.1111","volume":"95","author":[{"given":"Alina","family":"Cantemir","sequence":"first","affiliation":[{"name":"University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Iasi Romania"},{"name":"Oftaprof Clinic Ia\u015fi Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4226-3779","authenticated-orcid":false,"given":"Anisia\u2010Iuliana","family":"Alexa","sequence":"additional","affiliation":[{"name":"University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Iasi Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogdan Gabriel","family":"Galan","sequence":"additional","affiliation":[{"name":"Sanoptic Clinic Iasi Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoleta","family":"Anton","sequence":"additional","affiliation":[{"name":"University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Iasi Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana Elena","family":"Ciuntu","sequence":"additional","affiliation":[{"name":"University of Medicine and Pharmacy \u201cGrigore T. 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