{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T01:17:40Z","timestamp":1778894260148,"version":"3.51.4"},"reference-count":59,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"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\/Objectives: Keratoconus (KC) is a corneal ectatic disease, characterized by the progressive thinning of the cornea, myopia, and astigmatism, which lead to a decrease in visual acuity. Corneal collagen crosslinking (CXL) is an efficient method of stopping the progression of the disease. The objective of this study is to investigate the endothelial and biomechanical properties of the cornea in keratoconus patients, before and after undergoing corneal collagen crosslinking. Methods: A total of 66 eyes were diagnosed with progressive keratoconus and were recommended epi-off corneal crosslinking. Before the procedure, they were investigated with corneal topography (for minimum, maximum, average keratometry, and corneal astigmatism), specular microscopy (for the following endothelial cell parameters: number, density, surface, variability, and hexagonality), and an ocular response analyzer (for the following biomechanical parameters: corneal hysteresis and resistance factor). All measurements were repeated 1 month and 6 months after the intervention. Results: Several parameters differ according to the Amsler\u2013Krumeich stage of keratoconus: in more advanced stages, patients present higher endothelial cell variability, a lower number of endothelial cells in the paracentral region of the cornea, lower CCT and CRF, and higher keratometry and astigmatism. Endothelial cell variability and number correlate with average keratometry, and there are also strong correlations between topography and CH and CRF. After CXL, the paracentral number of endothelial cells decreased; cell variability and average cell surface increased. Conclusions: More advanced keratoconus cases present with altered corneal biomechanics and topographical parameters, the endothelial layer also being affected proportional to the stage of the disease and also slightly affected after corneal collagen crosslinking.<\/jats:p>","DOI":"10.3390\/jcm14134489","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T05:53:13Z","timestamp":1750917193000},"page":"4489","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Corneal Crosslinking on Endothelial and Biomechanical Parameters in Keratoconus"],"prefix":"10.3390","volume":"14","author":[{"given":"Maria-Silvia","family":"Dina","sequence":"first","affiliation":[{"name":"Doctoral School, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8242-8809","authenticated-orcid":false,"given":"Maria-Cristina","family":"Marinescu","sequence":"additional","affiliation":[{"name":"Doctoral School, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u0103t\u0103lina-Gabriela","family":"Corbu","sequence":"additional","affiliation":[{"name":"Oftaclinic Ophthalmology Clinic, 040254 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihaela-Monica","family":"Constantin","sequence":"additional","affiliation":[{"name":"Oftaclinic Ophthalmology Clinic, 040254 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u0103t\u0103lina-Ioana","family":"T\u0103taru","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u0103lin-Petru","family":"T\u0103taru","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.37358\/RC.19.4.7083","article-title":"Corneal Crosslinking in Progressive Keratoconus: Comparison of Dextran-Based and Hydroxypropyl Methylcellulose\u2014Based Riboflavin Solutions\u2014Differences in Demarcation Line Depth and 1 Year Outcomes","volume":"70","author":"Burcel","year":"2019","journal-title":"Rev. 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