{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T23:51:35Z","timestamp":1780098695528,"version":"3.54.0"},"reference-count":28,"publisher":"Wiley","license":[{"start":{"date-parts":[[2019,7,8]],"date-time":"2019-07-08T00:00:00Z","timestamp":1562544000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["NRF-2019R1C1C1007663"],"award-info":[{"award-number":["NRF-2019R1C1C1007663"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2019,7,8]]},"abstract":"<jats:p><jats:italic>Purpose<\/jats:italic>. To report one-year outcomes of a modified version of two-stage multimodal surgical protocol for moderate keratoconus which has been suggesting promising preliminary results.<jats:italic> Materials and Methods<\/jats:italic>. 30 eyes of 25 patients with moderate keratoconus who exhibited visual complaints and\/or disease progression were included for this retrospective case study. Approximately 3 months after implantation of intracorneal ring segment (Intacs SK\u2122), a combination of corneal wavefront-guided transepithelial photorefractive keratectomy (CWG-transPRK, Schwind Amaris\u00ae 1050, and Schwind Sirius) and accelerated collagen cross-linking (accCXL, Avedro KXL\u2122) was performed. Patients were examined for uncorrected and corrected distance visual acuity (UDVA; CDVA), keratometric power (K), corneal thickness, and corneal higher-order aberrations (HOAs) preoperatively and at postoperative 1, 3, 6, and 12 months.<jats:italic> Results<\/jats:italic>. The median UDVA and mean CDVA were enhanced from 6\/38 to 6\/12 and from 6\/19 to 6\/7.5, respectively, through 12 months after CWG-transPRK\/accCXL. The 12-month CDVA of all patients was better than 6\/12 Snellen, and no subject lost one or more lines of CDVA. The magnitudes of both myopia and corneal steepness were decreased in turn by Intacs SK implantation and also by CWG-transPRK\/accCXL, but the reduction in HOA was largely the result of CWG-transPRK\/accCXL. The magnitude of corneal thinning stabilized within 3 months after CWG-transPRK\/accCXL.<jats:italic> Conclusion<\/jats:italic>. This approach may allow patients with moderate keratoconus to obtain satisfactory vision without the need for contact lens wear. This surgery appeared to be effective and safe through 1 year of follow-up.<\/jats:p>","DOI":"10.1155\/2019\/7850216","type":"journal-article","created":{"date-parts":[[2019,7,8]],"date-time":"2019-07-08T19:31:55Z","timestamp":1562614315000},"page":"1-10","source":"Crossref","is-referenced-by-count":8,"title":["One-Year Efficacy and Safety of Combined Photorefractive Keratectomy and Accelerated Corneal Collagen Cross-Linking after Intacs SK Intracorneal Ring Segment Implantation in Moderate Keratoconus"],"prefix":"10.1155","volume":"2019","author":[{"given":"Il Hwan","family":"Koh","sequence":"first","affiliation":[{"name":"SU Yonsei Eye Clinic, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9855-1980","authenticated-orcid":true,"given":"Kyoung Yul","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Institute of Vision Research, Eye and Ear Hospital, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seong Bae","family":"Park","sequence":"additional","affiliation":[{"name":"SU Yonsei Eye Clinic, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hun","family":"Yang","sequence":"additional","affiliation":[{"name":"SU Yonsei Eye Clinic, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"InSik","family":"Kim","sequence":"additional","affiliation":[{"name":"SU Yonsei Eye Clinic, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Sun","family":"Kim","sequence":"additional","affiliation":[{"name":"SU Yonsei Eye Clinic, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David G.","family":"Hwang","sequence":"additional","affiliation":[{"name":"Cornea Service and Refractive Surgery Service, Department of 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