{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T02:07:43Z","timestamp":1783476463967,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,6,27]],"date-time":"2019-06-27T00:00:00Z","timestamp":1561593600000},"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":["Clinical Exper Ophthalmology"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Importance<\/jats:title><jats:p>Keratoconus is a debilitating condition with a disproportionately high impact on health resources and vision\u2010specific quality of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>This study aimed to compare 2\u2010year outcomes of epithelium\u2010off pulsed (p\u2010ACXL) and epithelium\u2010off continuous (c\u2010ACXL) accelerated corneal crosslinking in progressive keratoconus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective, interventional case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Eighty eyes of 80 patients were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The visual, refractive and tomographic results of the two crosslinking protocols were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Uncorrected distance visual acuity, corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE) and maximum keratometry (<jats:italic>K<\/jats:italic><jats:sub>MAX<\/jats:sub>) on corneal tomography assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean patient age was 22.51\u2009\u00b1\u20096.12\u2009years (SD) and 22.08\u2009\u00b1\u20095.72\u2009years in the p\u2010ACXL and c\u2010ACXL groups, respectively. The mean CDVA significantly improved from 0.30\u2009\u00b1\u20090.16 logMAR at baseline to 0.23\u2009\u00b1\u20090.17 logMAR at 24\u2009months (<jats:italic>P\u2009=<\/jats:italic> .04) in the p\u2010ACXL group and from 0.36\u2009\u00b1\u20090.22 logMAR to 0.26\u2009\u00b1\u20090.27 logMAR (<jats:italic>P\u2009=<\/jats:italic> .02) in the c\u2010ACXL group. The mean induced change in MRSE (+1.79\u2009\u00b1\u20092.30\u2009D vs +0.27\u2009\u00b1\u20093.19\u2009D, <jats:italic>P\u2009=<\/jats:italic> .04) and <jats:italic>K<\/jats:italic><jats:sub>MAX<\/jats:sub> (\u22121.75\u2009\u00b1\u20091.80\u2009D vs \u22120.39\u2009\u00b1\u20091.95\u2009D, <jats:italic>P\u2009=<\/jats:italic> .04) were superior in the c\u2010ACXL group compared to the p\u2010ACXL group at 24\u2009months. No complications were encountered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this prospective study, both p\u2010ACXL and c\u2010ACXL treatments were safe methods to halt the progression of keratoconus within a follow\u2010up period of 24\u2009months. c\u2010ACXL appeared to offer superior refractive and tomographic outcomes when compared to p\u2010ACXL but this did not translate into better visual outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ceo.13567","type":"journal-article","created":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T16:16:18Z","timestamp":1559837778000},"page":"980-986","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Prospective two\u2010year study of clinical outcomes following epithelium\u2010off pulsed versus continuous accelerated corneal crosslinking for keratoconus"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1289-3796","authenticated-orcid":false,"given":"Mohammed","family":"Ziaei","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, New Zealand National Eye Centre University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akilesh","family":"Gokul","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, New Zealand National Eye Centre University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Vellara","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, New Zealand National Eye Centre University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, New Zealand National Eye Centre University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9994-4631","authenticated-orcid":false,"given":"Dipika","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, New Zealand National Eye Centre University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles N. J.","family":"McGhee","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, New Zealand National Eye Centre University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.2013.278"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/795738"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2015.03.010"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00347-002-0700-3"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1006\/exer.1997.0410"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(02)02220-1"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.13-13748"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.11-9385"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2015.01.014"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2004.04.031"},{"key":"e_1_2_6_12_1","first-page":"CD009700","article-title":"Deep anterior lamellar keratoplasty versus penetrating keratoplasty for treating keratoconus","volume":"7","author":"Keane M","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/02713680490513182"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.15-18769"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijo.IJO_648_17"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2014.07.005"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S59840"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.3928\/1081597X-20160204-03"},{"key":"e_1_2_6_19_1","first-page":"4238","article-title":"Conventional vs. pulsed\u2010light accelerated corneal collagen cross\u2010linking for the treatment of progressive keratoconus: 12\u2010month results from a prospective study","volume":"14","author":"Jiang LZ","year":"2017","journal-title":"Exp Ther Med"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2017.10.044"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000000723"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/604731"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.2014.163"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2015.04.033"}],"container-title":["Clinical &amp; Experimental Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ceo.13567","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ceo.13567","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ceo.13567","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T12:20:53Z","timestamp":1694175653000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ceo.13567"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,27]]},"references-count":23,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1111\/ceo.13567"],"URL":"https:\/\/doi.org\/10.1111\/ceo.13567","archive":["Portico"],"relation":{},"ISSN":["1442-6404","1442-9071"],"issn-type":[{"value":"1442-6404","type":"print"},{"value":"1442-9071","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6,27]]},"assertion":[{"value":"2019-01-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}