{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:29:32Z","timestamp":1787059772944,"version":"build-2736575974"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,18]]},"DOI":"10.7759\/cureus.114728","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:09:31Z","timestamp":1787058571000},"source":"Crossref","is-referenced-by-count":0,"title":["Rapid Growth and Persistent Geographic Concentration of Recorded Outpatient Corneal Cross-Linking Production in Brazil\u2019s Unified Health System, 2017-2025"],"prefix":"10.7759","author":[{"given":"Matheus G","family":"Mau\u00e9s","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vict\u00f3ria","family":"Amin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Rezende","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Rodrigues","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000004170","article-title":"Global consensus on keratoconus and ectatic diseases-edition 2","volume":"45","author":"Gomes JA","year":"2026","unstructured":"Gomes JA, Hafezi F, Ambr\u00f3sio R Jr, et al.. Global consensus on keratoconus and ectatic diseases-edition 2. Cornea. 2026, 45:888-908. 10.1097\/ICO.0000000000004170","journal-title":"Cornea"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000003973","article-title":"Global incidence and prevalence of keratoconus: a systematic review and meta-analysis","volume":"45","author":"Sriranganathan A","year":"2026","unstructured":"Sriranganathan A, Chan CC, Dhillon J, Felfeli T. Global incidence and prevalence of keratoconus: a systematic review and meta-analysis. Cornea. 2026, 45:1080-92. 10.1097\/ICO.0000000000003973","journal-title":"Cornea"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(02)02220-1","article-title":"Riboflavin\/ultraviolet-A-induced collagen crosslinking for the treatment of keratoconus","volume":"135","author":"Wollensak G","year":"2003","unstructured":"Wollensak G, Spoerl E, Seiler T. Riboflavin\/ultraviolet-A-induced collagen crosslinking for the treatment of keratoconus. Am J Ophthalmol. 2003, 135:620-7. 10.1016\/S0002-9394(02)02220-1","journal-title":"Am J Ophthalmol"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2021.04.019","article-title":"Effect of corneal cross-linking versus standard care on keratoconus progression in young patients: the KERALINK randomized controlled trial","volume":"128","author":"Larkin DF","year":"2021","unstructured":"Larkin DF, Chowdhury K, Burr JM, et al.. Effect of corneal cross-linking versus standard care on keratoconus progression in young patients: the KERALINK randomized controlled trial. Ophthalmology. 2021, 128:1516-26. 10.1016\/j.ophtha.2021.04.019","journal-title":"Ophthalmology"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1111\/ceo.13959","article-title":"Five-year results of a prospective, randomised, contralateral eye trial of corneal crosslinking for keratoconus","volume":"49","author":"Meyer JJ","year":"2021","unstructured":"Meyer JJ, Jordan CA, Patel DV, et al.. Five-year results of a prospective, randomised, contralateral eye trial of corneal crosslinking for keratoconus. Clin Exp Ophthalmol. 2021, 49:542-9. 10.1111\/ceo.13959","journal-title":"Clin Exp Ophthalmol"},{"key":"ref6","doi-asserted-by":"publisher","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 SA","year":"2023","unstructured":"Greenstein SA, Yu AS, Gelles JD, Huang S, Hersh PS. Long-term outcomes after corneal cross-linking for progressive keratoconus and corneal ectasia: a 10-year follow-up of the pivotal study. Eye Contact Lens. 2023, 49:411-6. 10.1097\/ICL.0000000000001018","journal-title":"Eye Contact Lens"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000000460","article-title":"Does corneal collagen cross-linking reduce the need for keratoplasties in patients with keratoconus?","volume":"34","author":"Sandvik GF","year":"2015","unstructured":"Sandvik GF, Thorsrud A, R\u00e5en M, \u00d8stern AE, S\u00e6thre M, Drolsum L. Does corneal collagen cross-linking reduce the need for keratoplasties in patients with keratoconus?. Cornea. 2015, 34:991-5. 10.1097\/ICO.0000000000000460","journal-title":"Cornea"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1111\/aos.13095","article-title":"Nationwide reduction in the number of corneal transplantations for keratoconus following the implementation of cross-linking","volume":"94","author":"Godefrooij DA","year":"2016","unstructured":"Godefrooij DA, Gans R, Imhof SM, Wisse RP. Nationwide reduction in the number of corneal transplantations for keratoconus following the implementation of cross-linking. Acta Ophthalmol. 2016, 94:675-8. 10.1111\/aos.13095","journal-title":"Acta Ophthalmol"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph21121569","article-title":"Cost-effectiveness of corneal collagen crosslinking for progressive keratoconus: a Brazilian Unified Health System perspective","volume":"21","author":"Hansen LO","year":"2024","unstructured":"Hansen LO, Garcia R, Torricelli AAM, Bechara SJ. Cost-effectiveness of corneal collagen crosslinking for progressive keratoconus: a Brazilian Unified Health System perspective. Int J Environ Res Public Health. 2024, 21:1569. 10.3390\/ijerph21121569","journal-title":"Int J Environ Res Public Health"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.5935\/0004-2749.20160082","article-title":"Crosslinking enters public health armamentarium in Brazil","volume":"79","author":"Chamon W","year":"2016","unstructured":"Chamon W. Crosslinking enters public health armamentarium in Brazil. Arq Bras Oftalmol. 2016, 79:V-VI. 10.5935\/0004-2749.20160082","journal-title":"Arq Bras Oftalmol"},{"key":"ref11","unstructured":"Ministry of Health, Brazil. Ordinance No. 30 of September 20, 2016. Incorporation of corneal cross-linking for the treatment of keratoconus within the Unified Health System. (2016). Accessed: July 25, 2026: https:\/\/www.gov.br\/conitec\/pt-br\/midias\/relatorios\/2016\/relatorio_crosslinking_ceratocone_final.pdf\/@@display-file\/file."},{"key":"ref12","unstructured":"Ministry of Health, Brazil. Ordinance No. 486 of March 6, 2017. Protocol for the use of corneal cross-linking in the treatment of keratoconus. (2017). Accessed: July 25, 2026: https:\/\/www.gov.br\/conitec\/pt-br\/midias\/protocolos\/protocolo_uso\/protocolouso_crosslinking.pdf."},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1590\/1413-81232024291.00322023","article-title":"Implementation of health technologies in Brazil: analysis of federal guidelines for the public health system","volume":"29","author":"Silva SN","year":"2024","unstructured":"Silva SN, Mello NF, Ribeiro LR, Silva RE, Cota G. Implementation of health technologies in Brazil: analysis of federal guidelines for the public health system. Cien Saude Colet. 2024, 29:e00322023. 10.1590\/1413-81232024291.00322023","journal-title":"Cien Saude Colet"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1590\/S2237-96222022000300013","article-title":"Analysis of access to health services in Brazil according to sociodemographic profile: National Health Survey, 2019","volume":"31","author":"Palmeira NC","year":"2022","unstructured":"Palmeira NC, Moro JP, Getulino FA, Vieira YP, Soares Junior AO, Saes MO. Analysis of access to health services in Brazil according to sociodemographic profile: National Health Survey, 2019. Epidemiol Serv Saude. 2022, 31:e2022966. 10.1590\/S2237-96222022000300013","journal-title":"Epidemiol Serv Saude"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1590\/1413-81232017224.31382016","article-title":"Challenges for ensuring availability and accessibility to health care services under Brazil's Unified Health System (SUS)","volume":"22","author":"Oliveira APC","year":"2017","unstructured":"Oliveira APC, Gabriel M, Dal Poz MR, Dussault G. Challenges for ensuring availability and accessibility to health care services under Brazil's Unified Health System (SUS). Cien Saude Colet. 2017, 22:1165-80. 10.1590\/1413-81232017224.31382016","journal-title":"Cien Saude Colet"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040296","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"4","author":"von Elm E","year":"2007","unstructured":"von Elm E, Altman DG, Egger M, Pocock SJ, G\u00f8tzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med. 2007, 4:e296. 10.1371\/journal.pmed.0040296","journal-title":"PLoS Med"},{"key":"ref17","unstructured":"Ministry of Health, Brazil. DATASUS: SUS Outpatient Production (SIA\/SUS): technical notes. (2026). Accessed: July 25, 2026: https:\/\/datasus.saude.gov.br\/acesso-a-informacao\/producao-ambulatorial-sia-sus\/."},{"key":"ref18","unstructured":"National Health Council, Brazil. Resolution No. 674 of May 6, 2022. Classification and processing of research protocols within the CEP\/Conep system. (2022). Accessed: July 25, 2026: https:\/\/www.gov.br\/conselho-nacional-de-saude\/pt-br\/atos-normativos\/resolucoes\/2022\/resolucao-no-674.pdf."},{"key":"ref19","article-title":"Estimates of the Resident Population of Brazil and Its Federative Units as of July 1, 2025","author":"Brazilian Institute of Geography and Statistics","year":"2025","unstructured":"Brazilian Institute of Geography and Statistics. Estimates of the Resident Population of Brazil and Its Federative Units as of July 1, 2025. IBGE, Rio de Janeiro; 2025."},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2024.11.023","article-title":"Socioeconomic and demographic disparities in keratoconus treatment","volume":"271","author":"Erukulla R","year":"2025","unstructured":"Erukulla R, Soleimani M, Woodward M, et al.. Socioeconomic and demographic disparities in keratoconus treatment. Am J Ophthalmol. 2025, 271:424-35. 10.1016\/j.ajo.2024.11.023","journal-title":"Am J Ophthalmol"}],"container-title":["Cureus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cureus.com\/articles\/526407-rapid-growth-and-persistent-geographic-concentration-of-recorded-outpatient-corneal-cross-linking-production-in-brazils-unified-health-system-2017-2025","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:09:32Z","timestamp":1787058572000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cureus.com\/articles\/526407-rapid-growth-and-persistent-geographic-concentration-of-recorded-outpatient-corneal-cross-linking-production-in-brazils-unified-health-system-2017-2025"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,18]]},"references-count":20,"URL":"https:\/\/doi.org\/10.7759\/cureus.114728","relation":{},"ISSN":["2168-8184"],"issn-type":[{"value":"2168-8184","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8,18]]}}}