{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T19:12:12Z","timestamp":1789499532846,"version":"build-2803163510"},"reference-count":45,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,6,16]],"date-time":"2023-06-16T00:00:00Z","timestamp":1686873600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>The present study evaluated the effectiveness and safety of corneal collagen cross-linking (CXL). A total of 886 eyes with progressive keratoconus were enrolled in a retrospective cohort study in a tertiary care university hospital. CXL was performed using a standard epithelium-off Dresden protocol. Visual outcomes, maximum keratometry (Kmax), demarcation line measurements, and complications were recorded. Visual outcomes and keratometric data were analyzed in a subgroup comprising 610 eyes. Uncorrected distance visual acuity (UDVA) improved from 0.49 \u00b1 0.38 LogMAR to 0.47 \u00b1 0.39 LogMAR (p = 0.03, n = 610) three years after the procedure, while corrected distance visual acuity (CDVA) improved from 0.15 \u00b1 0.14 LogMAR to 0.14 \u00b1 0.15 LogMAR (p = 0.007, n = 610). A significant reduction of Kmax from 56.28 \u00b1 6.10 to 54.98 \u00b1 6.19 (p &lt; 0.001, n = 610) was observed three years after CXL. In five eyes (0.82%, 5\/610) keratoconus progression continued after CXL. Three eyes were retreated successfully with documented refractive and topographic stability after five years. In the 35 eyes that completed 10 years of follow-up, mean visual acuity and topographic parameters remained stable. In conclusion, CXL is a safe and effective treatment for avoiding keratoconus progression. Long-term data are encouraging, supporting a high safety profile for this procedure.<\/jats:p>","DOI":"10.3390\/medsci11020043","type":"journal-article","created":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T02:29:19Z","timestamp":1687141759000},"page":"43","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Safety and Efficacy of Corneal Cross-Linking in Patients Affected by Keratoconus: Long-Term Results"],"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, Via Olgettina 60, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola Noemi","family":"Genovese","sequence":"additional","affiliation":[{"name":"Cornea and Ocular Surface Unit, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Paganoni","sequence":"additional","affiliation":[{"name":"Cornea and Ocular Surface Unit, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oriella","family":"Ambrosio","sequence":"additional","affiliation":[{"name":"Cornea and Ocular Surface Unit, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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, Via Olgettina 60, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Zennato","sequence":"additional","affiliation":[{"name":"Cornea and Ocular Surface Unit, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela","family":"Caccia","sequence":"additional","affiliation":[{"name":"Cornea and Ocular Surface Unit, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeleine","family":"Cataldo","sequence":"additional","affiliation":[{"name":"Cornea and Ocular Surface Unit, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Rama","sequence":"additional","affiliation":[{"name":"Cornea and Ocular Surface Unit, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,16]]},"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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