{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T18:58:52Z","timestamp":1768071532233,"version":"3.49.0"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,10,3]],"date-time":"2018-10-03T00:00:00Z","timestamp":1538524800000},"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":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To compare the effect of corneal collagen cross\u2010linking (<jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content>) on progressive keratoconus using 0.1% riboflavin with either dextran or methylcellulose as the main supplement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a comparative case series, <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> was performed in 40 patients (40 eyes) using a riboflavin solution containing either dextran (dextran\u2013riboflavin; <jats:italic>n<\/jats:italic>\u00a0=\u00a020) or methylcellulose (methylcellulose\u2013riboflavin; <jats:italic>n<\/jats:italic>\u00a0=\u00a020). Changes in central corneal thickness (<jats:styled-content style=\"fixed-case\">CCT<\/jats:styled-content>), Scheimpflug tomography, maximal keratometry reading (<jats:italic>K<\/jats:italic><jats:sub>max<\/jats:sub>), visual acuity (VA) and endothelial cell density (<jats:styled-content style=\"fixed-case\">ECD<\/jats:styled-content>) were recorded. Stromal changes one month after surgery were analysed using optical coherence tomography (<jats:styled-content style=\"fixed-case\">OCT<\/jats:styled-content>) and <jats:italic>in\u00a0vivo<\/jats:italic> confocal microscopy (<jats:styled-content style=\"fixed-case\">IVCM<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">CCT<\/jats:styled-content> was significantly higher in the methylcellulose\u2013riboflavin group during the <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> procedure. The <jats:styled-content style=\"fixed-case\">IVCM<\/jats:styled-content> demarcation line depth was 274\u00a0\u00b1\u00a080 (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>) <jats:italic>\u03bc<\/jats:italic>m in the dextran\u2013riboflavin group and 442\u00a0\u00b1\u00a080\u00a0<jats:italic>\u03bc<\/jats:italic>m in the methylcellulose\u2013riboflavin group (p\u00a0&lt;\u00a00.001). Complete absence of keratocytes in the pre\u2010endothelial stroma was found in none of the corneas treated with dextran\u2013riboflavin and in 42% of the corneas treated with methylcellulose\u2013riboflavin. Visibility of the <jats:styled-content style=\"fixed-case\">OCT<\/jats:styled-content> demarcation line was significantly lower in the methylcellulose\u2013riboflavin group. <jats:italic>K<\/jats:italic><jats:sub>max<\/jats:sub> and corrected distance visual acuity were improved in the methylcellulose\u2013riboflavin group and stable in the dextran\u2013riboflavin group after 2\u00a0years. Endothelial cell density (<jats:styled-content style=\"fixed-case\">ECD<\/jats:styled-content>) was stable in both groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We found deeper structural changes in the methylcellulose\u2013riboflavin group than in the dextran\u2013riboflavin group. This may be explained by different riboflavin solution properties and raises safety concerns. The study also indicates improved effect using methylcellulose\u2013riboflavin than dextran\u2013riboflavin, possibly explained by deeper stromal <jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content> effect.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.13928","type":"journal-article","created":{"date-parts":[[2018,10,5]],"date-time":"2018-10-05T18:15:02Z","timestamp":1538763302000},"page":"415-421","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Superior outcome of corneal collagen cross\u2010linking using riboflavin with methylcellulose than riboflavin with dextran as the main supplement"],"prefix":"10.1111","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1645-3405","authenticated-orcid":false,"given":"Andreas","family":"Thorsrud","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Oslo University Hospital Oslo Norway"},{"name":"Center for Eye Research University 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