{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:30:12Z","timestamp":1791491412333,"version":"4.3.4"},"reference-count":24,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[2014,6,18]],"date-time":"2014-06-18T00:00:00Z","timestamp":1403049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"},{"start":{"date-parts":[[2014,6,18]],"date-time":"2014-06-18T00:00:00Z","timestamp":1403049600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Rep Ophthalmol"],"abstract":"<b><i>Purpose:<\/i><\/b> To report a novel application of toric topographically customized transepithelial collagen cross-linking (CXL) aiming to achieve refractive astigmatic changes in a keratoconic cornea. <b><i>Methods:<\/i><\/b> Specially formulated riboflavin transepithelial administration and delivery of high-fluence UVA in a topographically customized pattern was applied in an eye with progressive keratoconus. Visual acuity, cornea clarity, keratometry, topography, and pachymetry with a multitude of modalities, as well as endothelial cell counts were evaluated for >6 months. <b><i>Results:<\/i><\/b> Uncorrected distance visual acuity changed from preoperative 20\/40 to 20\/25 at 6 months. A mean astigmatic reduction of 0.8 D, and significant cornea surface normalization was achieved 6 months postoperatively. There was some mild change in the epithelial distribution, with the treated area having a slight normalization in the average epithelial thickness. <b><i>Conclusions:<\/i><\/b> We introduce herein the novel application of a topographically customizable transepithelial CXL in progressive keratoconus in order to achieve an astigmatic refractive effect and ectasia stabilization. This novel technique offers a nonablative and nonincisional approach to treat irregular astigmatism in ectatic cornea with rapid visual rehabilitation.<\/jats:p>","DOI":"10.1159\/000363371","type":"journal-article","created":{"date-parts":[[2014,6,18]],"date-time":"2014-06-18T12:38:22Z","timestamp":1403095102000},"page":"172-180","source":"Crossref","is-referenced-by-count":42,"title":["Toric Topographically Customized Transepithelial, Pulsed, Very High-Fluence, Higher Energy and Higher Riboflavin Concentration Collagen Cross-Linking in Keratoconus"],"prefix":"10.1159","volume":"5","author":[{"given":"Anastasios John","family":"Kanellopoulos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J.","family":"Dupps","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Seven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Asimellis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2014,6,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2013.06.013"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.exer.2013.04.010"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e3182a9fbdf"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e3182a02ddb"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.5301\/ejo.5000249"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2012.01.026"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3928\/1081597X-20140120-03"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S44745"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1115\/1.4025980"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2014.03.019"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S53718"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S44741"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2011.01.029"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2007.03.041"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2007.07.028"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S27170"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.3928\/1081597X-20110705-01"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.4103\/0301-4738.116074"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.3928\/1081597X-20121005-05"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S31256"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.3928\/1081597X-20130515-06"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S59934"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S31250"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e3182a15cee"}],"container-title":["Case Reports in Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/363371","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/363371","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T17:48:28Z","timestamp":1745430508000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000363371"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,6,18]]},"references-count":24,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2014,8,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000363371","archive":["Portico"],"relation":{},"ISSN":["1663-2699"],"issn-type":[{"value":"1663-2699","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,6,18]]}}}