{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:20:11Z","timestamp":1787840411221,"version":"build-2784847793"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To assess the long-term safety and stability of visual outcomes following the modified technique of collagen crosslinking (CXL) using refractive lenticule in eyes with thin corneas (&lt;400 \u00b5m) and progressive keratoconus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>A tertiary eye care hospital in India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Prospective, interventional case series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Eyes with progressive keratoconus and thin corneas (&lt;400 \u00b5m) underwent CXL with intraoperative stromal augmentation using a refractive lenticule obtained from small-incision lenticule extraction (SMILE). Preoperative and postoperative evaluation (3 months, and then yearly thereafter) included corneal tomography (Oculus Pentacam), uncorrected and corrected distance visual acuity (UDVA and CDVA, respectively), manifest refraction, and endothelial cell count (specular microscopy), and adverse events, if any, were noted. The patients were followed up for a period of 5 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Seven eyes were included in the analysis. Mean corneal flattening of -4.29 D was noted from preoperative maximum keratometry (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.018). An improvement in UDVA and CDVA of 0.38 logarithm of minimum angle of resolution (logMAR) and 0.36 logMAR, respectively, was noted at 5 years postoperative visit. Four eyes demonstrated a gain of two lines in CDVA. Mean spherical equivalent improved from \u22126.85 D preoperatively to \u22126.05 D at 5 years postoperatively. Clear demarcation line was noted between 230 to 270 \u00b5m on anterior segment optical coherence topography. No significant endothelial cell loss was noted postoperatively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Long-term outcomes demonstrated safety and disease stability following lenticule-assisted CXL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_762_23","type":"journal-article","created":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T01:04:45Z","timestamp":1703207085000},"page":"94-97","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Long-term outcomes of tailored stromal expansion with refractive lenticule for crosslinking thin corneas"],"prefix":"10.4103","volume":"72","author":[{"given":"Gitansha S","family":"Sachdev","sequence":"first","affiliation":[{"name":"Cornea and Refractive Services, The Eye Foundation, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mithun","family":"Thulasidas","sequence":"additional","affiliation":[{"name":"Centre for Sight Group of Eye Hospitals, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahipal S","family":"Sachdev","sequence":"additional","affiliation":[{"name":"Centre for Sight Group of Eye Hospitals, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,12,22]]},"reference":[{"key":"R1-20260508","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 Ophthalmol"},{"key":"R2-20260508","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1006\/exer.1997.0410","article-title":"Induction of cross-links in corneal 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