{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:00:40Z","timestamp":1792425640419,"version":"4.5.0"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T00:00:00Z","timestamp":1700438400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To analyse the temperature of the corneal surface in keratoconus during corneal customized crosslinking (CXL) with a preserved epithelium (epi\u2010on) under oxygen flow, and epi\u2010off CXL in room air, and to assess the effect of pre\u2010heating the oxygen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This masked, intra\u2010individual comparing randomized study included 14 participants with bilateral progressive keratoconus treated with bilateral CXL: one eye with epi\u2010on CXL under a flow of 2.5\u2009L\/min oxygen; the fellow eye with epi\u2010off CXL in room air. In a second setting involving 12 healthy participants, room\u2010tempered oxygen was flushed over one eye and oxygen pre\u2010heated to 37\u00b0C over the fellow eye. The corneal surface temperature was assessed with infrared photography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A reduction in corneal surface temperature was seen from the pre\u2010treatment application of topical riboflavin in the epi\u2010off group (\u22121.1\u2009\u00b1\u20091.0\u00b0C, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The temperature increased during the first half of the CXL treatment in both groups (+0.7\u2009\u00b1\u20091.2\u00b0C, <jats:italic>p<\/jats:italic>\u2009=\u20090.041 for epi\u2010on; +0.7\u2009\u00b1\u20090.9\u00b0C, <jats:italic>p<\/jats:italic>\u2009=\u20090.023 for epi\u2010off CXL, respectively). In epi\u2010on CXL an overall temperature increase was seen during the treatment (+0.8\u2009\u00b1\u20091.2\u00b0C, <jats:italic>p<\/jats:italic>\u2009=\u20090.016). In the second setting, pre\u2010heating the oxygen rendered a surface temperature increase of +1.8\u2009\u00b1\u20090.2\u00b0C (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In epi\u2010off CXL, the application of topical room\u2010tempered riboflavin decreases the corneal surface temperature, likely due to increased evaporation. A slight temperature increase is seen during CXL with both epi\u2010on and epi\u2010off CXL, albeit far below the corneal safety limit. The corneal temperature can, however, be increased by applying pre\u2010heated oxygen, a possible approach to modify or augment the treatment effect in CXL.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.15817","type":"journal-article","created":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T10:49:30Z","timestamp":1700563770000},"page":"529-534","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Thermographic analysis of the corneal surface in epi\u2010on and epi\u2010off corneal crosslinking for keratoconus"],"prefix":"10.1111","volume":"102","author":[{"given":"Anneli","family":"Fredriksson","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences\/Ophthalmology Ume\u00e5 University  Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofie","family":"Elving","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences\/Ophthalmology Ume\u00e5 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