{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:36:11Z","timestamp":1786649771583,"version":"build-2736575974"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T00:00:00Z","timestamp":1682899200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:p>\n                    Corneal cross-linking (CXL), a corneal strengthening procedure, is known to alter anterior stroma swelling behavior and is one of the treatment modalities of bullous keratopathy (BK). There are multiple studies published on the role of CXL in the treatment of BK. These articles had heterogeneous study population, different protocols used, and variable conclusions. This systematic review aimed to determine the role of CXL in the treatment of BK. The primary outcomes considered were changes in central corneal thickness (CCT) after 1, 3, and 6 months of CXL. The secondary outcome measures were changes in visual acuity, corneal clarity, subjective symptoms, and complications after CXL. We included randomized control trials (RCTs), observational and interventional studies, and case series with reports of more than 10 cases in this review. In RCTs, the mean pre-CXL CCT (794.0 \u00b1 178.5 \u03bcm) in the intervention group (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 37), decreased at 1 month (750.9 \u00b1 154.3 \u03bcm) followed by a subsequent increase, but this difference was not significant during the 6-month follow-up (\n                    <jats:italic toggle=\"yes\">P-<\/jats:italic>\n                    value 0.28, 0.82, and 0.82 at 1, 3, and 6 months, respectively). In noncomparative clinical studies (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 188), the mean pre-CXL CCT (794.0 \u00b1 178.5 \u03bcm) decreased at 1 month (710.9 \u00b1 127.2 \u03bcm,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.0001). Seven of the 11 articles included in the review reported no significant improvement in vision with CXL. The initial improvement in corneal clarity and clinical symptoms was not sustained. Current evidence suggests that CXL has short-term efficacy in the treatment of BK. More RCTs with high-quality evidence are needed.\n                  <\/jats:p>","DOI":"10.4103\/ijo.ijo_1942_22","type":"journal-article","created":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T03:23:21Z","timestamp":1684293801000},"page":"1706-1717","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Role of corneal collagen cross-linking in bullous keratopathy: A systematic review"],"prefix":"10.4103","volume":"71","author":[{"given":"Mamta","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, All India Institute of Medical Sciences, Rajkot, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bibhuti Prassan","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, RIO, IGIMS, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, RIO, IMS, BHU, Varanasi, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunal","family":"Deokar","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, All India Institute of Medical Sciences, Rajkot, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gayatri","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, All India Institute of Medical Sciences, Rajkot, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garima","family":"Upreti","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, All India Institute of Medical Sciences, Rajkot, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,5,17]]},"reference":[{"key":"R1-20251006","doi-asserted-by":"crossref","first-page":"1815","DOI":"10.2147\/OPTH.S89163","article-title":"Recurrent rates and risk factors associated with recurrent painful bullous keratopathy after primary phototherapeutic keratectomy","volume":"9","author":"Kasetsuwan","year":"2015","journal-title":"Clin Ophthalmol"},{"key":"R2-20251006","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.jcjo.2016.07.005","article-title":"Current indications and surgical approaches to corneal transplants at the University of Toronto:A clinical-pathological study","volume":"52","author":"Le","year":"2017","journal-title":"Can J Ophthalmol"},{"key":"R3-20251006","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1097\/ICO.0000000000001707","article-title":"Corneal cross-linking:Current USA status:Report from the cornea 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History"}},{"value":"2023-01-30","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}