{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:30:16Z","timestamp":1786649416528,"version":"build-2736575974"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4]]},"abstract":"Abstract<\/jats:title>\n \n Purpose:<\/jats:title>\n To evaluate the long-term effects of accelerated corneal cross-linking (ACXL) in stabilizing progressive keratoconus (KC), as these effects remain unclear.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n This 5-year longitudinal study included 49 eyes with progressive KC who underwent 10-min ACXL. Baseline and posttreatment assessments included uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), refractive error (sphere, cylinder, and spherical equivalent), corneal curvature indices (maximum keratometry [Kmax], flat keratometry [K1], steep keratometry [K2], and mean keratometry), corneal thickness, and corneal irregularity indices (index of height asymmetry [IHA], index of surface variance [ISV], and inferior\u2013superior value [IS-value]). Corneal imaging was performed using Pentacam and Corvis ST. Longitudinal changes were analyzed using repeated-measures statistical models.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Significant improvements were observed in UCVA and BCVA over time (\n P<\/jats:italic>\n = 0.001). Keratometric indices (K1, K2, and Kmax) initially declined, indicating corneal flattening, followed by a mild regression at later time points (\n P<\/jats:italic>\n < 0.005). Corneal thickness (thinnest location) decreased transiently but stabilized by year 5 (\n P<\/jats:italic>\n = 0.003). Corneal topographic indices revealed mixed trends: corneal densitometry increased progressively (\n P<\/jats:italic>\n = 0.001), suggesting long-term structural changes. Corneal irregularity indices (IHA, ISV, IS-value, and index of vertical asymmetry) demonstrated initial fluctuations but overall improvement, reflecting enhanced corneal regularity (\n P<\/jats:italic>\n < 0.05). Posterior radius of curvature initially increased, then decreased at year 5 (\n P<\/jats:italic>\n = 0.016), indicating late risk for posterior corneal steepening. Progression indices (progression index max and IS-value) showed a downward trend, supporting disease stabilization (\n P<\/jats:italic>\n = 0.028).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n This study supports the long-term efficacy of 10-min ACXL in stabilizing progressive KC, with sustained improvements in corneal irregularity indices and visual function. Early 10-min ACXL intervention is recommended to be considered for maximizing stabilization and preventing advanced disease progression.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/joco.joco_62_25","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T14:00:35Z","timestamp":1766152835000},"page":"207-213","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Long-Term Outcomes of 10-Minute Accelerated Corneal Cross-Linking on Structural, Topographic, and Tomographic Corneal Parameters: A 5-Year Prospective Study"],"prefix":"10.4103","volume":"37","author":[{"given":"Mehrdad","family":"Mohammadpour","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Farabi Eye Hospital and Eye Research Center, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaghayegh","family":"Esfandiari","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Farabi Eye Hospital and Eye Research Center, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siamak","family":"Afaghi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Farabi Eye Hospital and Eye Research Center, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hesam","family":"Hashemian","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Farabi Eye Hospital and Eye Research Center, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"key":"R1-20251222","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1016\/j.ophtha.2019.02.029","article-title":"Keratoconus natural progression: A systematic review and meta-analysis of 11 529 eyes","volume":"126","author":"Ferdi","year":"2019","journal-title":"Ophthalmology"},{"key":"R3-20251222","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1097\/ICO.0b013e3182a0d014","article-title":"Prevalence of keratoconus in a population-based study in Shahroud","volume":"32","author":"Hashemi","year":"2013","journal-title":"Cornea"},{"key":"R4-20251222","doi-asserted-by":"crossref","first-page":"289","DOI":"10.2174\/1874364101812010289","article-title":"Epidemiology of keratoconus worldwide","volume":"12","author":"Omer","year":"2018","journal-title":"Open Ophthalmol 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Imaging Med Surg"},{"key":"R14-20251222","doi-asserted-by":"crossref","first-page":"5566","DOI":"10.1038\/s41598-023-32822-y","article-title":"The intra- and inter-day repeatability of corneal densitometry measurements in subjects with keratoconus and in healthy controls","volume":"13","author":"Gustafsson","year":"2023","journal-title":"Sci Rep"},{"key":"R15-20251222","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1097\/ICL.0000000000001018","article-title":"Long-term outcomes after corneal cross-linking for progressive keratoconus and corneal ectasia: A 10-year follow-up of the pivotal study","volume":"49","author":"Greenstein","year":"2023","journal-title":"Eye Contact Lens"},{"key":"R16-20251222","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1097\/ICO.0000000000000248","article-title":"Long-term follow-up of corneal collagen cross-linking for keratoconus \u2013The Cretan study","volume":"33","author":"Kymionis","year":"2014","journal-title":"Cornea"},{"key":"R17-20251222","doi-asserted-by":"crossref","first-page":"1472","DOI":"10.1080\/02713683.2022.2117383","article-title":"Long-term outcome of corneal collagen crosslinking with riboflavin and UV-a irradiation for keratoconus","volume":"47","author":"Seifert","year":"2022","journal-title":"Curr Eye Res"},{"key":"R18-20251222","doi-asserted-by":"crossref","first-page":"1865","DOI":"10.2147\/OPTH.S409009","article-title":"Long term corneal flattening after corneal crosslinking in patients with progressive keratoconus","volume":"17","author":"Henriquez","year":"2023","journal-title":"Clin Ophthalmol"},{"key":"R19-20251222","first-page":"43","article-title":"Safety and efficacy of corneal cross-linking in patients affected by keratoconus: Long-term results","volume":"11","author":"Knutsson","year":"2023","journal-title":"Med Sci (Basel)"},{"key":"R20-20251222","doi-asserted-by":"crossref","first-page":"249","DOI":"10.4274\/tjo.45220","article-title":"Topography and higher order corneal aberrations of the fellow eye in unilateral keratoconus","volume":"47","author":"Aksoy","year":"2017","journal-title":"Turk J Ophthalmol"},{"key":"R21-20251222","doi-asserted-by":"crossref","first-page":"19642","DOI":"10.1038\/s41598-024-70084-4","article-title":"Longitudinal assessment of the progression of severe keratoconus based on corneal topography","volume":"14","author":"Yang","year":"2024","journal-title":"Sci Rep"},{"key":"R22-20251222","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.joco.2019.10.003","article-title":"Keratoconus indices and their determinants in healthy eyes of a rural population","volume":"32","author":"Hashemi","year":"2020","journal-title":"J Curr Ophthalmol"}],"container-title":["Journal of Current 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