{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T19:48:03Z","timestamp":1780084083559,"version":"3.54.0"},"reference-count":40,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2021,10,30]],"date-time":"2021-10-30T00:00:00Z","timestamp":1635552000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Ophthalmology"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate the long-term outcomes of corneal cross-linking (CXL) in patients with progressive keratoconus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>In this retrospective non-comparative study, forty-five eyes of 31 patients with progressive keratoconus were treated with 30\u2005min \u201cepi-off\u201d corneal cross-linking. The visual, refractive, topographic and tomographic outcomes were evaluated preoperatively and at least 10 years after cross-linking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ten years post-corneal cross-linking, the mean anterior maximum keratometry decreased (\u22122.10\u2009\u00b1\u20093.25 D, P\u2009=\u20090.0001). Conversely, the posterior maximum keratometry increased (6.38\u2009\u00b1\u20099.79 D, P\u2009=\u20090.065). Both uncorrected and corrected distance visual acuity improved (LogMAR \u22120.08\u2009\u00b1\u20090.30) and (LogMAR \u22120.05\u2009\u00b1\u20090.21), respectively (P &gt; 0.05, both). A statistically significant hyperopic shift was observed postoperatively (0.70\u2009\u00b1\u20091.31 D, P\u2009=\u20090.0009). The anterior topographic cylinder values revealed no change (\u22120.17\u2009\u00b1\u20091.31 D, P\u2009=\u20090.3), whereas the mean posterior cylinder values decreased (absolute value increased) significantly compared to baseline from \u22121.31\u2009\u00b1\u20090.97 D to \u22121.82\u2009\u00b1\u20091.78 D, (P &lt; 0.05). The minimum corneal thickness values decreased significantly (\u221235.11\u2009\u00b1\u200948.63\u2005\u00b5m, P\u2009=\u20090.0001). Four eyes (8.8%) showed more than 1 D increase in the anterior maximum keratometry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This protocol and duration of Epi-off corneal cross-linking was found to be effective in halting keratoconus progression over the follow up period (10 years). Anterior corneal flattening and a hyperopic shift were observed. A statistically significant increase in the posterior corneal cylinder was observed. Although, not reaching statistical significance, the logMAR uncorrected and corrected visual acuity were improved.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11206721211052878","type":"journal-article","created":{"date-parts":[[2021,10,30]],"date-time":"2021-10-30T05:08:45Z","timestamp":1635570525000},"page":"50-58","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":21,"title":["Long-term visual, anterior and posterior corneal changes after crosslinking for progressive keratoconus"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1042-8153","authenticated-orcid":false,"given":"Abdelrahman","family":"Salman","sequence":"first","affiliation":[{"name":"Honorary Clinical Lecturer at Tishreen University, Scientific Director of Tratous Specialist Eye Center(Tartous, Syria), Lattakia, Syrian Arab 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