{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:17:43Z","timestamp":1787314663516,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100010817","name":"Stiftelsen Kronprinsessan Margaretas Arbetsn\u00e4mnd f\u00f6r Synskadade","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010817","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002960","name":"V\u00e4sterbotten L\u00e4ns Landsting","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002960","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010810","name":"\u00d6gonfonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010810","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effects of customized corneal collagen cross\u2010linking (CXL) on higher\u2010order aberrations (HOAs) in keratoconus (KC): vertical coma (VC), horizontal coma (HC), spherical aberration (SA), trefoil (TF) and astigmatism, compared with the same effects in healthy eyes undergoing CXL for low\u2010grade myopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This mixed\u2010designed study included 38 eyes of 38 patients with KC, treated and followed prospectively, who received customized epi\u2010on CXL in high oxygen, and a retrospective control group of 23 eyes from 23 patients who underwent central 4\u2010mm CXL treatment for low\u2010grade myopia. VC, HC, SA, TF and keratometry values were obtained from Pentacam HR\u00ae measurements at baseline and at 1, 6, 12 and 24\u2009months post\u2010treatment. Statistical analyses included paired T\u2010tests for changes over time and Pearson correlation tests to assess relationships between aberrations, best spectacle\u2010corrected and low\u2010contrast visual acuities (BSCVA and LCVA, respectively) and CXL parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Reduced HOAs and improved visual acuities were observed in KC. A 20% reduction in VC was observed at 24\u2009months (from \u22121.82\u2009\u00b1\u20091.15\u2009\u03bcm to \u22121.46\u2009\u00b1\u20091.01\u2009\u03bcm; 95% CI: [0.155, 0.629],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), while a 17% reduction in HC was observed at 12\u2009months (from \u22120.35\u2009\u00b1\u20090.56\u2009\u03bcm to \u22120.29\u2009\u00b1\u20090.62\u2009\u03bcm; 95% CI: [0.003, 0.096],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037). A positive correlation was found between baseline VC and the level of improvement in VC at 24\u2009months (\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.200,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015). SA increased by 126% at 24\u2009months (from \u22120.21\u2009\u00b1\u20090.62\u2009\u03bcm to 0.054\u2009\u00b1\u20090.52\u2009\u03bcm; 95% CI: [0.143, 0.347],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.001). TF and astigmatism did not alter from the treatment. In myopia, the natural positive SA increased by 57% post\u2010treatment (from 0.14\u2009\u00b1\u20090.061\u2009\u03bcm to 0.22\u2009\u00b1\u20090.076\u2009\u03bcm at 24\u2009months; 95% CI: [0.067, 0.098],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.001), while changes in VC and HC were minor and BSCVA remained stable.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Customized CXL effectively reduces HOAs in KC. For VC the improvement is larger in cases with higher preoperative VC, indicating that the concept of customization has its intended effect. Accordingly, SA and visual acuities improve in KC whereas CXL for low\u2010grade myopia tends to increase corneal SA unfavourably.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aos.17432","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T05:45:51Z","timestamp":1734587151000},"page":"966-973","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effects of customized corneal cross\u2010linking on higher\u2010order aberrations in progressive keratoconus and low\u2010grade myopia"],"prefix":"10.1111","volume":"103","author":[{"given":"Jad","family":"Hayek","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences\/Ophthalmology Ume\u00e5 University  Ume\u00e5 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