{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T03:59:19Z","timestamp":1781409559586,"version":"3.54.1"},"reference-count":39,"publisher":"Wiley","license":[{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Wilmer Biostatistics","award":["P30EY001765"],"award-info":[{"award-number":["P30EY001765"]}]},{"name":"Wilmer Eye Institute","award":["P30EY001765"],"award-info":[{"award-number":["P30EY001765"]}]},{"name":"Hymowitz Family Foundation","award":["P30EY001765"],"award-info":[{"award-number":["P30EY001765"]}]},{"name":"Kahn Foundation","award":["P30EY001765"],"award-info":[{"award-number":["P30EY001765"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Ophthalmology"],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"<jats:p>Purpose. To evaluate whether unilateral crosslinking (CXL) and conservative follow-up of the fellow eye is an acceptable management strategy in patients with keratoconus (KC). Methods. Seventy-nine fellow eyes of KC subjects that initially underwent unilateral CXL were included. Thirty fellow eyes ultimately received CXL (group 1) whereas 49 fellow eyes were followed (group 2). Best spectacle corrected visual acuity (BSCVA) and corneal tomographic parameters were collected in all eyes preoperatively and at the last follow-up. Results. Subjects who received CXL in the fellow eye (group 1) were younger than subjects who did not (group 2, <jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>p<\/a:mi>\n                        <a:mo>=<\/a:mo>\n                        <a:mn>0.026<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>). Group 1 eyes had higher baseline K1 (<jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>p<\/c:mi>\n                        <c:mo>=<\/c:mo>\n                        <c:mn>0.026<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula>), K2 (<jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>p<\/e:mi>\n                        <e:mo>=<\/e:mo>\n                        <e:mn>0.006<\/e:mn>\n                     <\/e:math>\n                  <\/jats:inline-formula>), Km (<jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mi>p<\/g:mi>\n                        <g:mo>=<\/g:mo>\n                        <g:mn>0.01<\/g:mn>\n                     <\/g:math>\n                  <\/jats:inline-formula>), and Kmax (<jats:inline-formula>\n                     <i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                        <i:mi>p<\/i:mi>\n                        <i:mo>=<\/i:mo>\n                        <i:mn>0.002<\/i:mn>\n                     <\/i:math>\n                  <\/jats:inline-formula>) compared to group 2 eyes. Amongst the 49 na\u00efve fellow eyes (group 2), 19 eyes showed evidence of progression. Progressing na\u00efve eyes had higher baseline K1, K2, Km, and Kmax (<jats:inline-formula>\n                     <k:math xmlns:k=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\">\n                        <k:mi>p<\/k:mi>\n                        <k:mo>&lt;<\/k:mo>\n                        <k:mn>0.01<\/k:mn>\n                     <\/k:math>\n                  <\/jats:inline-formula>); progressors also had thinner pachymetry at the pupil, apex, and thinnest point (<jats:inline-formula>\n                     <m:math xmlns:m=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\">\n                        <m:mi>p<\/m:mi>\n                        <m:mo>&lt;<\/m:mo>\n                        <m:mn>0.01<\/m:mn>\n                     <\/m:math>\n                  <\/jats:inline-formula>). Baseline values of K1\u2009\u2265\u200943.5 Diopter (D), K2\u2009&gt;\u200945.1D, Km\u2009&gt;\u200944.3D, Kmax\u2009&gt;\u200947.9D, astigmatism\u2009&gt;\u20091.4D, pachymetry at the pupil &lt;475\u2009\u03bcm, and thinnest pachymetry &lt;478\u2009\u03bcm were tentative predictors of progression in the na\u00efve fellow eye. Conclusions. Unilateral CXL with vigilant follow up of the fellow eye may be an acceptable management strategy in a subset of KC eyes.<\/jats:p>","DOI":"10.1155\/2022\/4661392","type":"journal-article","created":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T22:50:30Z","timestamp":1654123830000},"page":"1-7","source":"Crossref","is-referenced-by-count":1,"title":["Crosslinking vs. Observation in Fellow Eyes of Keratoconus Patients"],"prefix":"10.1155","volume":"2022","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4318-7966","authenticated-orcid":true,"given":"Gavin","family":"Li","sequence":"first","affiliation":[{"name":"Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0958-4383","authenticated-orcid":true,"given":"Laura","family":"Di Meglio","sequence":"additional","affiliation":[{"name":"Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1715-3981","authenticated-orcid":true,"given":"Jiangxia","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9401-4283","authenticated-orcid":true,"given":"Fasika A.","family":"Woreta","sequence":"additional","affiliation":[{"name":"Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7873-7406","authenticated-orcid":true,"given":"Kraig S.","family":"Bower","sequence":"additional","affiliation":[{"name":"Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4429-2004","authenticated-orcid":true,"given":"Vishal","family":"Jhanji","sequence":"additional","affiliation":[{"name":"UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2366-235X","authenticated-orcid":true,"given":"Divya","family":"Srikumaran","sequence":"additional","affiliation":[{"name":"Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1678-6437","authenticated-orcid":true,"given":"Uri S.","family":"Soiberman","sequence":"additional","affiliation":[{"name":"Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2016.12.015"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1097\/00055735-199508000-00009"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6257(97)00119-7"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1038\/eye.2013.278"},{"key":"5","article-title":"Keratoconus","volume-title":"StatPearls. 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