{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T03:35:00Z","timestamp":1793417700239,"version":"4.5.0"},"reference-count":44,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,5,28]],"date-time":"2023-05-28T00:00:00Z","timestamp":1685232000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Purpose: To determine the 6-month effect of conventional (CXL30) and accelerated cross-linking with a UVA intensity of 9 mW\/cm2 (CXL10) on corneal stability and to investigate whether there was a difference in ABCD grading system parameters regarding the two different procedures. Methods: Twenty-eight eyes of 28 patients with a documented keratoconus (KN) progression were included. Patients were selected to undergo either epi off CXL30 or CXL10. At the baseline and the follow-up visits after one (V1), three (V2), and six months (V3), the patients underwent complete ophthalmic examination and corneal tomography. Results: In the CXL30 group, all the parameters from the ABCD grading system significantly changed from baseline to V3; parameter A decreased (p = 0.048), B and C increased (p = 0.010, p &lt; 0.001), and D decreased (p &lt; 0.001). In the CXL10 group, there were no changes in parameters A (p = 0.247) and B (p = 0.933), though parameter C increased (p = 0.001) and D decreased (p &lt; 0.001). After an initial decline after one month, visual acuity (VA) recovered on V2 and V3 (p &lt; 0.001), and median maximal keratometry (Kmax) decreased in both groups (p = 0.001, p = 0.035). In the CXL30 group, there were significant changes in other parameters; average pachymetric progression index (p &lt; 0.001), Ambr\u00f3sio relational thickness maximum (ARTmax) (p = 0.008), front and back mean keratometry (p &lt; 0.001), pachymetry apex (PA) (p &lt; 0.001), and front elevation (p = 0.042). However, in the CXL10 group, there were significant changes only in ARTmax (p = 0.019) and PA (p &lt; 0.001). Conclusion: Both epi-off CXL protocols showed similar short-term efficacy in improving VA and Kmax, halting the progression of KN, and both similarly changed tomographic parameters. However, the conventional protocol modified the cornea more significantly.<\/jats:p>","DOI":"10.3390\/medicina59061043","type":"journal-article","created":{"date-parts":[[2023,5,28]],"date-time":"2023-05-28T15:29:52Z","timestamp":1685287792000},"page":"1043","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Short-Term Effect of Conventional Versus Accelerated Corneal Cross-Linking Protocol on Corneal Geography and Stability"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8229-7826","authenticated-orcid":false,"given":"Sania","family":"Vidas Pauk","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Zagreb University Hospital Center, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja","family":"Jandrokovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Zagreb University Hospital Center, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, \u0160alata 2, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dina","family":"Le\u0161in Ga\u0107ina","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Zagreb University Hospital Center, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7535-3631","authenticated-orcid":false,"given":"Martina","family":"Tomi\u0107","sequence":"additional","affiliation":[{"name":"Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Dugi dol 4a, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4808-2968","authenticated-orcid":false,"given":"Tomislav","family":"Bulum","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Zagreb, \u0160alata 2, 10000 Zagreb, Croatia"},{"name":"Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Dugi dol 4a, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Pupi\u0107 Bakra\u010d","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Zagreb University Hospital Center, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7137-5059","authenticated-orcid":false,"given":"Tomislav","family":"Kuzman","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Zagreb University Hospital Center, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, \u0160alata 2, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josip","family":"Kne\u017eevi\u0107","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Zagreb University Hospital Center, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miro","family":"Kalauz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Zagreb University Hospital Center, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, \u0160alata 2, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1016\/j.ophtha.2017.03.052","article-title":"United States multicenter clinical trial of corneal collagen crosslinking for keratoconus treatment","volume":"124","author":"Hersh","year":"2017","journal-title":"Ophthalmology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/0039-6257(84)90094-8","article-title":"Keratoconus and related noninflammatory corneal thinning disorders","volume":"28","author":"Krachmer","year":"1984","journal-title":"Surv. 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