{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T10:51:32Z","timestamp":1778064692015,"version":"3.51.4"},"reference-count":31,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T00:00:00Z","timestamp":1669766400000},"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>A large retrospective study evaluated the safety of a post-operative therapy protocol after epithelium-off corneal collagen cross-linking (CXL). In total, 1703 eyes of the 1190 patients with progressive keratoconus were enrolled in a retrospective cohort study in a tertiary care university hospital. CXL was performed using a standardized technique (Dresden protocol: 0.1% riboflavin solution containing dextran 20% for 30 min during the soaking phase followed by 30-min ultraviolet A irradiation (3 mW\/cm2)). Postoperatively, a bandage contact lens was applied, and therapy included a topical fluoroquinolone antibiotic until the epithelium healed, followed by topical fluorometholone treatment for three weeks. Post-operative complications were recorded and analyzed. No cases of infectious keratitis occurred, whereas peripheral sterile infiltrates were observed in 1.17% of cases. Trace haze was typically present but did not have an impact on visual acuity. In fifteen cases (0.88%), visually significant anterior stromal opacity developed. Mild signs of dry eye were observed in 22 eyes (1.29%). The present study demonstrates that a post-operative treatment protocol including fluoroquinolone antibiotics and a BCL in the first phase until complete epithelial healing, followed by a three-week period of topical steroid treatment is safe and not associated with the development of microbial keratitis.<\/jats:p>","DOI":"10.3390\/jcm11237093","type":"journal-article","created":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T07:10:27Z","timestamp":1669792227000},"page":"7093","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Evaluation of a Post-Operative Therapy Protocol after Epithelium-Off Corneal Cross-Linking in Patients Affected by Keratoconus"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9615-2839","authenticated-orcid":false,"given":"Karl Anders","family":"Knutsson","sequence":"first","affiliation":[{"name":"Cornea and Ocular Surface Unit, San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola Noemi","family":"Genovese","sequence":"additional","affiliation":[{"name":"Cornea and Ocular Surface Unit, San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgio","family":"Paganoni","sequence":"additional","affiliation":[{"name":"Cornea and Ocular Surface Unit, San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oriella","family":"Ambrosio","sequence":"additional","affiliation":[{"name":"Cornea and Ocular Surface Unit, San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6474-9908","authenticated-orcid":false,"given":"Giulio","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Cornea and Ocular Surface Unit, San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arianna","family":"Zennato","sequence":"additional","affiliation":[{"name":"Cornea and Ocular Surface Unit, San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madeleine","family":"Cataldo","sequence":"additional","affiliation":[{"name":"Cornea and Ocular Surface Unit, San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michela","family":"Caccia","sequence":"additional","affiliation":[{"name":"Cornea and Ocular Surface Unit, San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Rama","sequence":"additional","affiliation":[{"name":"Cornea and Ocular Surface Unit, San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.1016\/j.ophtha.2021.04.019","article-title":"Effect of Corneal Cross-linking versus Standard Care on Keratoconus Progression in Young Patients: The keralink randomized controlled trial","volume":"128","author":"Larkin","year":"2021","journal-title":"Ophthalmology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2137","DOI":"10.1016\/j.jcrs.2011.08.026","article-title":"Corneal collagen crosslinking in progressive keratoconus: Multicenter results from the French National Reference Center for Keratoconus","volume":"37","author":"Asri","year":"2011","journal-title":"J. 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