{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T14:43:02Z","timestamp":1782139382686,"version":"3.54.5"},"reference-count":20,"publisher":"Wiley","license":[{"start":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T00:00:00Z","timestamp":1514764800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Ophthalmology"],"published-print":{"date-parts":[[2018]]},"abstract":"<jats:p><jats:italic>Purpose<\/jats:italic>. To analyze the results of three-year outcomes of combined epithelium-on cross-linking with femtosecond laser ICRS (cross-linking PLUS) for keratoconus management. <jats:italic>Design<\/jats:italic>. A retrospective multicenter clinical study. <jats:italic>Methods<\/jats:italic>. 43 eyes of 38 patients were subjected to preoperative and postoperative UCVA, BCVA, refraction, Pentacam pachymetry, and keratometry examinations at 3-, 6-, 12-, 24-, and 36-month follow-up period. <jats:italic>Results<\/jats:italic>. The preoperative and postoperative mean UCVA was 1.30\u2009\u00b1\u20090.48 (logMAR\u2009\u00b1\u2009SD) and 0.82\u2009\u00b1\u20090.22 respectively. The preoperative and postoperative mean BCVA was 0.90\u2009\u00b1\u20090.40 and 0.60\u2009\u00b1\u20090.30, respectively. The preoperative and postoperative mean K average was 50.63\u2009\u00b1\u20090.87 (D\u2009\u00b1\u2009SD) and 45.56\u2009\u00b1\u20090.98, respectively. The preoperative and postoperative mean pachymetry was 471\u2009\u00b1\u200992.36 (<jats:italic>\u03bc<\/jats:italic>m\u2009\u00b1\u2009SD) and 423\u2009\u00b1\u200939.58, respectively. The preoperative and postoperative mean astigmatism was 7.55\u2009\u00b1\u20091.75 and 3.39\u2009\u00b1\u20091.26, respectively. One eye showed ICRS edge exposure while 6 eyes showed progression of keratoconus. <jats:italic>Conclusion<\/jats:italic>. CXL PLUS was proved to be a successful procedure to halt progression (mainly by CXL) and to correct the refractive status of the keratoconic eye (mainly by ICRS). CXL PLUS performed a synergistic action correcting and maintaining the correction of both myopic and astigmatic components of keratoconus.<\/jats:p>","DOI":"10.1155\/2018\/6907573","type":"journal-article","created":{"date-parts":[[2018,1,17]],"date-time":"2018-01-17T18:33:49Z","timestamp":1516214029000},"page":"1-8","source":"Crossref","is-referenced-by-count":22,"title":["Three-Year Outcomes of Cross-Linking PLUS (Combined Cross-Linking with Femtosecond Laser Intracorneal Ring Segments Implantation) for Management of Keratoconus"],"prefix":"10.1155","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7954-1277","authenticated-orcid":true,"given":"Mohammed Iqbal Hafez","family":"Saleem","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Sohag University, Sohag, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hosam A.","family":"Ibrahim Elzembely","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Minia University, Minia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mortada Ahmed","family":"AboZaid","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Sohag University, Sohag, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7967-3421","authenticated-orcid":true,"given":"Mohammed","family":"Elagouz","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Sohag University, Sohag, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Mohamed","family":"Saeed","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Banha University, Banha, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama Ali","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Sohag University, Sohag, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Gad","family":"Kamel","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Sohag University, Sohag, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.5005\/jp-journals-10025-1002"},{"key":"2","first-page":"890","volume-title":"Ectatic disorders of the cornea","volume":"1","year":"2006"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/916385"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2013-304132"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1186\/s40662-016-0038-6"},{"key":"6","volume":"20","year":"2013"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2007.12.022"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e3182215a15"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.3928\/1081597X-20140711-10"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e3181e2cf57"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2009.12.031"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S97158"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.5301\/ejo.5000020"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.4103\/1110-9173.195268"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/2927546"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2010.179580"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.4103\/2090-0686.168716"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.4103\/2090-0686.148163"},{"key":"19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfo.2013.11.012"},{"key":"20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2015.02.005"}],"container-title":["Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/joph\/2018\/6907573.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/joph\/2018\/6907573.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/joph\/2018\/6907573.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,1,17]],"date-time":"2018-01-17T18:33:49Z","timestamp":1516214029000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/joph\/2018\/6907573\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018]]},"references-count":20,"alternative-id":["6907573","6907573"],"URL":"https:\/\/doi.org\/10.1155\/2018\/6907573","relation":{},"ISSN":["2090-004X","2090-0058"],"issn-type":[{"value":"2090-004X","type":"print"},{"value":"2090-0058","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018]]}}}