{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T07:18:37Z","timestamp":1785568717053,"version":"3.56.0"},"reference-count":10,"publisher":"SLACK, Inc.","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Refract Surg"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:sec>\n            <jats:title>PURPOSE:<\/jats:title>\n            <jats:p>To report the long-term clinical outcome in a patient diagnosed as having bilateral progressive keratoconus who received a single corneal collagen cross-linking (CXL) treatment in the right eye and repeated CXL in the left eye.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>\n              Observational case report. Topographical changes were assessed by high-resolution Scheimpflug imaging. The right eye underwent a standard epithelium-off CXL procedure in February 2008, followed by the left eye 4 weeks later. In 2012, the left eye was treated with CXL for a second time. Irradiation was performed in all cases at a fluence of 5.4 J\/cm\n              <jats:sup>2<\/jats:sup>\n              . Energy settings were 30 minutes @ 3 mW\/cm\n              <jats:sup>2<\/jats:sup>\n              for the CXL procedures performed in 2008, and 10 minutes @ 9 mW\/cm\n              <jats:sup>2<\/jats:sup>\n              for the second CXL procedure of the left eye that was performed in 2012.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>The right eye that underwent a single CXL procedure showed a flattening of keratometry values between 2008 and 2012, followed by stabilization. The left eye showed a similar flattening effect between 2008 and 2012, followed by another flattening effect after the second CXL procedure and accompanied by a distinct increase in corrected distance visual acuity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Following repeated CXL, the corneal stroma and endothelium remained inconspicuous, and postoperative haze and visibility of the stromal demarcation line was similar to what is usually observed after a single CXL procedure. Whether the additive flattening effect of the anterior surface observed in this single case goes along with an additive increase in biomechanical stiffness remains to be seen.<\/jats:p>\n            <jats:p>\n              <jats:bold>\n                [\n                <jats:italic>J Refract Surg.<\/jats:italic>\n                2014;30(10):716\u2013718.]\n              <\/jats:bold>\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.3928\/1081597x-20140903-03","type":"journal-article","created":{"date-parts":[[2014,10,7]],"date-time":"2014-10-07T15:35:46Z","timestamp":1412696146000},"page":"716-718","source":"Crossref","is-referenced-by-count":23,"title":["Additive Effect of Repeated Corneal Collagen Cross-linking in Keratoconus"],"prefix":"10.3928","volume":"30","author":[{"given":"Farhad","family":"Hafezi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Tabibian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Richoz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2308","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtos.2013.01.002"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.12-11387"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0886-3350(03)00407-3"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M110.169813"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2009.03.035"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e31820143d1"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.13-13042"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1098\/rsif.2010.0108"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004179900111"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2009.07.039"}],"container-title":["Journal of Refractive Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.healio.com\/doiresolver?doi=10.3928\/1081597X-20140903-03","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T10:11:44Z","timestamp":1683108704000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.healio.com\/doi\/10.3928\/1081597X-20140903-03"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,10]]},"references-count":10,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2014,10]]}},"alternative-id":["10.3928\/1081597X-20140903-03"],"URL":"https:\/\/doi.org\/10.3928\/1081597x-20140903-03","relation":{},"ISSN":["1081-597X"],"issn-type":[{"value":"1081-597X","type":"print"}],"subject":[],"published":{"date-parts":[[2014,10]]}}}