{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:28:46Z","timestamp":1760059726920,"version":"build-2065373602"},"reference-count":66,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"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: To evaluate the efficacy and safety of using the preservative-free topical proxymetacaine hydrochloride (Minims, 0.5% w\/v, Bausch &amp; Lomb, UK) to control postoperative pain after epithelium-off corneal crosslinking (CXL) for keratoconus. Methods: This is an observational study of patients with mild to severe keratoconus who have undergone epithelium-off CXL. CXL was completed by applying dextran-free riboflavin (0.1%) for 10 min (Vibex Rapid; Avedro, Inc.), followed by continuous UV-A light (Avedro KXL system; Avedro, Inc.) for 30 min at an intensity of 3 mW\/cm2 and an energy of 5.4 J\/cm2. All patients were prescribed postoperative proxymetacaine hydrochloride PRN with an allowed frequency of up to eight times per 24 h for the first 3 days to control postoperative pain. Patients were reviewed at 1\u20132 weeks postoperatively for a comprehensive examination, including assessment of delayed corneal healing, removal of the bandage contact lens, and recording of subjective symptoms. Results: There were 223 eyes of 180 patients with a mean age of 24.9 \u00b1 8.6 years (range: 13\u201338 years). Male patients were 72%. At their planned first postoperative visit, we found no corneal healing abnormalities, such as persistent epithelial defects, epithelial irregularities, or early postoperative stromal haze, in any patient. All patients subjectively reported that proxymetacaine drops helped them to control postoperative pain, particularly in the first 48 h. Conclusions: None of the patients reported pain after 3 days of using proxymetacaine drops up to eight times a day for the first 3 days. It appears to be a safe and effective solution to control postoperative pain without any complications.<\/jats:p>","DOI":"10.3390\/jcm14134692","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T04:07:17Z","timestamp":1751515637000},"page":"4692","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Ten Years\u2019 Experience Using Proxymetacaine Hydrochloride 0.5% for Postoperative Pain Control in Epithelium-Off Corneal Crosslinking"],"prefix":"10.3390","volume":"14","author":[{"given":"Mohamed Gamal","family":"Elghobaier","sequence":"first","affiliation":[{"name":"Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Eastern Road, Brighton BN2 5BF, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6817-9161","authenticated-orcid":false,"given":"Issac","family":"Levy","sequence":"additional","affiliation":[{"name":"Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Eastern Road, Brighton BN2 5BF, UK"},{"name":"Ophthalmology Department, Rabin Medical Center, Petach Tikva 4941492, Israel"},{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0667-3700","authenticated-orcid":false,"given":"Mayank A.","family":"Nanavaty","sequence":"additional","affiliation":[{"name":"Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Eastern Road, Brighton BN2 5BF, UK"},{"name":"Brighton & Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9PX, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1006\/exer.1997.0410","article-title":"Induction of cross-links in corneal tissue","volume":"66","author":"Spoerl","year":"1998","journal-title":"Exp. 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