{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T06:54:14Z","timestamp":1781592854227,"version":"3.54.5"},"reference-count":0,"publisher":"Press of International Journal of Ophthalmology (IJO Press)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Ophthalmol"],"published-print":{"date-parts":[[2026,7,18]]},"abstract":"<jats:p>AIM: To report the 18-month clinical outcomes of the progressively higher fluence pulsed light (7.2 to 10 J\/cm2) epithelium-on accelerated corneal crosslinking (PFPL M Epi-On ACXL) protocol for progressive keratoconus.\nMETHODS: This was a prospective, non-randomized interventional study. Fluence was assigned based on preoperative pachymetry: 7.2 J\/cm2 (\u2264420 \u03bcm), 8.6 J\/cm2 (420\u2013459 \u03bcm), or 10 J\/cm2 (\u2265460 \u03bcm). Riboflavin solutions (Paracel I and II), pulsed ultraviolet-A (UVA) irradiation (1s on\/off), and consistent procedural timing (13min irradiation) were applied using the KXL I system. Uncorrected and best-corrected distance visual acuity (UDVA, CDVA), maximum keratometry (Kmax), higher-order aberrations (HOAs), and anterior segment optical coherence tomography (OCT) demarcation line depth were analyzed at baseline, 6, 12, and 18mo.\nRESULTS: Totally 32 eyes of 32 patients aged over 26y with progressive keratoconus underwent PFPL M Epi-On ACXL were included. All groups demonstrated long-term stability in UDVA and CDVA. The 10 J\/cm2 group showed the greatest improvement in CDVA (+0.17 decimal), significant corneal flattening (Kmax reduction: \u22121.03 D), and the most substantial HOAs reduction (\u22120.30 \u00b5m). No significant differences were observed between the 7.2 and 8.6 J\/cm2 groups. OCT showed fluence-dependent demarcation line depths: 250\u00b130 \u00b5m in the 10 J\/cm2 group. No adverse events were observed.<\/jats:p>","DOI":"10.18240\/ijo.2026.07.09","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T06:15:16Z","timestamp":1781590516000},"page":"1293-1299","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of progressive fluence pulsed light epithelium-on accelerated corneal cross-linking for progressive keratoconus: 18-month prospective results"],"prefix":"10.18240","volume":"19","author":[{"name":"Ferrise Eye Clinic, Lamezia Terme 88046, Italy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Ferrise","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana","family":"D'Esposito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Medicine and Surgery, University of Enna &#x201C;Kore&#x201D;, Piazza dell'Universit&#xE0;, Enna 94100, Italy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Cappellani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Medicine and Surgery, University of Enna &#x201C;Kore&#x201D;, Piazza dell'Universit&#xE0;, Enna 94100, Italy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Zagari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Vampolieri Eye Clinic, Acicastello 95021, Catania, Italy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cosimo","family":"Mazzotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Medicine and Surgery, University of Enna &#x201C;Kore&#x201D;, Piazza dell'Universit&#xE0;, Enna 94100, Italy; Siena Crosslinking Center, Via Sandro Pertini, Monteriggioni, Siena 53035, Italy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"7543","container-title":["International Journal of Ophthalmology"],"original-title":[],"link":[{"URL":"https:\/\/www.ijo.cn\/gjyken\/article\/pdf\/20260709","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T06:15:19Z","timestamp":1781590519000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ijo.cn\/gjyken\/article\/abstract\/20260709"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,18]]},"references-count":0,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7,18]]}},"URL":"https:\/\/doi.org\/10.18240\/ijo.2026.07.09","relation":{},"ISSN":["2222-3959","2227-4898"],"issn-type":[{"value":"2222-3959","type":"print"},{"value":"2227-4898","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,18]]}}}