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Animals studied: 24 horses (24 eyes) with stromal, ulcerative keratitis were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>12 horses were initially treated with<jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content>, and 12 horses were given conventional medical treatment. Topical medical treatment was added to horses in the<jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content>group if necessary. Parameters including cytology, microbial growth, time to fluorescein negativity, and time to inhibition of stromal melting were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After the first day of treatments, a decrease in inflammatory signs and pain from the eye was observed in both groups. Stromal melting ceased within 24\u00a0hours regardless of treatment.<jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content>treatment alone was sufficient in 3 horses with noninfectious, superficial stromal ulcerations. Clinical signs of impaired wound healing were seen after 3\u201014\u00a0days in corneas with suspected or proven bacterial infection treated with<jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content>only, most likely because of insufficient elimination of bacteria deeper in the corneal stroma or because of re\u2010infection from bacteria in the conjunctiva. The average decrease in stromal ulcer area per day after onset of treatment was almost identical between the groups, and no significant difference in time to fluorescein negativity was found.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We consider<jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content>a possible useful adjunct treatment of corneal stromal ulcers in horses, especially for melting ulcers and as a potential alternative to prophylactic antibiotic treatment for noninfected stromal ulcers. However,<jats:styled-content style=\"fixed-case\">CXL<\/jats:styled-content>should not be used alone for infected or suspected infected stromal ulcers, because topical antibiotics were required in all horses with proven infectious keratitis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/vop.12662","type":"journal-article","created":{"date-parts":[[2019,4,23]],"date-time":"2019-04-23T08:29:32Z","timestamp":1556008172000},"page":"552-562","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Corneal cross\u2010linking (CXL)\u2014A clinical study to evaluate CXL as a treatment in comparison with medical treatment for ulcerative keratitis in horses"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8016-9767","authenticated-orcid":false,"given":"Anna","family":"Hellander Edman","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences Swedish University of Agricultural Sciences 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