{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T18:59:49Z","timestamp":1768071589392,"version":"3.49.0"},"reference-count":30,"publisher":"SLACK, Inc.","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Refract Surg"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec>\n            <jats:title>PURPOSE:<\/jats:title>\n            <jats:p>To compare the 2-year follow-up outcomes of three groups of patients with keratoconus treated with transepithelial iontophoresis (I-CXL), iontophoresis with epithelial removal (I-SCXL), and standard epithelium-off (S-CXL) CXL for progressive keratoconus.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>Sixty eyes of 60 patients treated with CXL for progressive keratoconus were included in this comparative, prospective clinical study. Twenty patients were included in each group (I-CXL, I-SCXL, and S-CXL). Corrected distance visual acuity (CDVA), refraction, corneal topography, Scheimpflug tomography, and aberrometry were assessed at baseline and at 1, 3, 6, 12, and 24 months of follow-up. To assess the long-term safety and efficacy of these treatments, the preoperative values were compared with the values at 24 months of follow-up.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              The main outcome of the study was the non-statistically significant difference between the three protocols in induced change in most of the parameters, including visual acuity (\n              <jats:italic>P<\/jats:italic>\n              = .665), topographic indexes (all\n              <jats:italic>P<\/jats:italic>\n              &gt; .05), and maximum keratometry (\n              <jats:italic>P<\/jats:italic>\n              = .611) after 2 years of follow-up. There were no significant differences in the change in refractive error following CXL in all groups or between groups (all\n              <jats:italic>P<\/jats:italic>\n              &gt; .05). Conversely, I-CXL induced significantly less corneal thinning (\n              <jats:italic>P<\/jats:italic>\n              = .0299 and .0121) and a significantly greater reduction of higher order aberrations and coma (all\n              <jats:italic>P<\/jats:italic>\n              &lt; .0001) compared to S-CXL and I-SCXL. All protocols induced a significant increase in visual acuity (S-CXL\n              <jats:italic>P<\/jats:italic>\n              = .0004, I-SCXL\n              <jats:italic>P<\/jats:italic>\n              = .0045, and I-CXL\n              <jats:italic>P<\/jats:italic>\n              = .004).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>The 2-year results of this comparative, prospective clinical study demonstrate the efficacy and safety of I-CXL to treat progressive keratoconus and overcome the limitations of CXL with epithelial debridement.<\/jats:p>\n            <jats:p>\n              <jats:bold>\n                [\n                <jats:italic>J Refract Surg<\/jats:italic>\n                . 2019;35(3):184\u2013190.]\n              <\/jats:bold>\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.3928\/1081597x-20190128-01","type":"journal-article","created":{"date-parts":[[2019,3,11]],"date-time":"2019-03-11T11:40:07Z","timestamp":1552304407000},"page":"184-190","source":"Crossref","is-referenced-by-count":25,"title":["Iontophoresis CXL With and Without Epithelial Debridement Versus Standard CXL: 2-Year Clinical Results of a Prospective Clinical Study"],"prefix":"10.3928","volume":"35","author":[{"given":"Paolo","family":"Vinciguerra","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Rosetta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuela F.","family":"Legrottaglie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuela","family":"Morenghi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cosimo","family":"Mazzotta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen B.","family":"Kaye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riccardo","family":"Vinciguerra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2308","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6257(97)00119-7"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0886-3350(03)00407-3"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2009.10.021"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2008.09.048"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2012.10.023"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2007.12.039"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e31824d6fe3"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/869015"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2013.03.026"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3928\/1081597X-20100212-09"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2015.02.005"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/3720517"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.3928\/1081597X-20141021-06"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.3928\/1081597X-20160629-02"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2017.01.040"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/aos.13032"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/aos.13538"},{"key":"e_1_3_2_19_2","first-page":"S227","article-title":"The role of amino acids in corneal stromal healing: a method for evaluating cellular density and extracellular matrix distribution","volume":"19","author":"Torres Munoz I","year":"2003","unstructured":"Torres Munoz I, Grizzi F, Russo C, Camesasca FI, Dioguardi N, Vinciguerra P. The role of amino acids in corneal stromal healing: a method for evaluating cellular density and extracellular matrix distribution. J Refract Surg. 2003;19(suppl):S227\u2013S330.","journal-title":"J Refract Surg"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1038\/eye.2013.266"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0886-3350(02)01639-5"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-197601000-00005"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00347-014-3114-0"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2013.10.028"},{"key":"e_1_3_2_25_2","first-page":"1419","article-title":"Systematic review and eta-analysis comparing modified cross-linking and standard cross-linking for progressive keratoconus","volume":"10","author":"Liu Y","year":"2017","unstructured":"Liu Y, Liu Y, Zhang YN, et al. 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