{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T21:38:40Z","timestamp":1769549920921,"version":"3.49.0"},"reference-count":44,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,3,24]],"date-time":"2022-03-24T00:00:00Z","timestamp":1648080000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Corneal collagen cross-linking (CXL) has become the gold standard for mild and moderate stages to stop the progression of keratoconus. We analyzed some corneal topography indices to compare iontophoresis epi-on and iontophoresis epi-off techniques throughout a two-year follow-up. Methods: A total of 64 eyes of 49 patients who underwent CXL were recruited. In 30 eyes the epi-off technique was performed, whereas the remaining 34 eyes were treated with the epi-on technique. All patients underwent a complete ophthalmologic examination that included CDVA, central and thinnest corneal thickness, Schirmer test I, TBUT test, and the Ocular Surface Disease Index. Results: In both groups, a significant improvement in visual function was recorded. No statistically significant differences between Kmax, Mean K, Flat K, Steep K values were found. Statistically significant differences (p &lt; 0.05) between the epi-on and epi-off groups\u2019 pachymetry before and after 24 months follow-up as well as between the epi-on and epi-off groups\u2019 topographically thinnest point in the immediate post-surgery and 24 months after surgery were recorded. Conclusion: Our study highlighted that both techniques are valid in mid-term corneal stabilization. The advantage of the new iontophoresis epi-off cross-linking technique could be found in a faster imbibing time of the cornea, therefore reducing surgical times, with a lower risk of complications.<\/jats:p>","DOI":"10.3390\/jcm11071785","type":"journal-article","created":{"date-parts":[[2022,3,27]],"date-time":"2022-03-27T21:27:51Z","timestamp":1648416471000},"page":"1785","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Topographic Outcomes in Keratoconus Surgery: Epi-on versus Epi-off Iontophoresis Corneal Collagen Cross-Linking"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6044-7486","authenticated-orcid":false,"given":"Pasquale","family":"Napolitano","sequence":"first","affiliation":[{"name":"Department of Medicine and Health Sciences \u201cVincenzo Tiberio\u201d, University of Molise, 86100 Campobasso, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fausto","family":"Tranfa","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive Sciences and Dentistry, Eye Clinic, University of Naples \u201cFederico II\u201d, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1964-4899","authenticated-orcid":false,"given":"Luca","family":"D\u2019Andrea","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive Sciences and Dentistry, Eye Clinic, University of Naples \u201cFederico II\u201d, 80138 Naples, Italy"},{"name":"Public Health Department, Universit\u00e0 degli Studi di Napoli \u201cFederico II\u201d, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6023-4277","authenticated-orcid":false,"given":"Ciro","family":"Caruso","sequence":"additional","affiliation":[{"name":"Corneal Transplant Center, Pellegrini Hospital, Via Portamedina alla Pignasecca, 41, 80127 Napoli, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Rinaldi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Della Campania Luigi Vanvitelli, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Mazzucco","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive Sciences and Dentistry, Eye Clinic, University of Naples \u201cFederico II\u201d, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Ciampa","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive Sciences and Dentistry, Eye Clinic, University of Naples \u201cFederico II\u201d, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0797-6332","authenticated-orcid":false,"given":"Antonietta","family":"Melenzane","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive Sciences and Dentistry, Eye Clinic, University of Naples \u201cFederico II\u201d, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ciro","family":"Costagliola","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive Sciences and Dentistry, Eye Clinic, University of Naples \u201cFederico II\u201d, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"9426","DOI":"10.1038\/s41598-020-66442-7","article-title":"Characterization of Tear Immunoglobulins in a Small-Cohort of Keratoconus Patients","volume":"10","author":"McKay","year":"2020","journal-title":"Sci. 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