ArticleJournal of ophthalmology2018
Epi-Off versus Epi-On Corneal Collagen Cross-Linking in Keratoconus Patients: A Comparative Study through 2-Year Follow-Up.
Article in Journal of ophthalmology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 3 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Epithelium-on versus epithelium-off corneal collagen crosslinking for keratoconus: a systematic review and meta-analysis.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2024Pooled it
- Transepithelial Versus Epithelium-Off Corneal Crosslinking for Progressive Keratoconus: Findings From a Cochrane Systematic Review.American journal of ophthalmology · 2021Pooled it
- Transepithelial versus epithelium-off corneal crosslinking for progressive keratoconus.The Cochrane database of systematic reviews · 2021Pooled it
- Vitamin E TPGS-enhanced riboflavin accelerated transepithelial cross-linking versus accelerated epithelium-off protocol in progressive keratoconus: a prospective randomized trial.International ophthalmology · 2026Trial
- Observation and assessment of the immediate use of a silicon hydrogel contact lens after transepithelial corneal cross linking: a prospective study.BMC ophthalmology · 2023Trial
- The efficiency and safety of oxygen-supplemented accelerated transepithelial corneal cross-linking.International ophthalmology · 2021Trial
- The Science and Clinical Evolution of Corneal Cross-Linking: Mechanism of Action, Ultra-Structural Changes, Clinical Indications, and Emerging Treatment Strategies.Ophthalmology and therapy · 2026Review
- Short-term retinal microvascular and structural changes after epi-on and epi-off corneal cross-linking assessed by SD-OCTA.International ophthalmology · 2026Article
- Regional Biomechanical and Topographic Changes after Transepithelial vs. Epithelium-off Continuous Accelerated Corneal Cross-linking in Keratoconus: Updated Stress-Strain Index as a Superior Biomarker.Ophthalmology science · 2026Article
- Review
- The Clinical Significance of the Early Screening of Keratoconus and Its Impact on Maintaining Quality of Life.Life (Basel, Switzerland) · 2026Article
- The microenvironment of ocular surface in keratoconus: a systematic review.Eye and vision (London, England) · 2025Review
- Photochemical corneal cross-linking: Evaluating the potential of a hand-held biopen.Materials today. Bio · 2025Article
- Long-Term Outcomes in Crosslinking Therapy for Patients with Progressive Keratoconus.Diagnostics (Basel, Switzerland) · 2025Article
- Efficacy and Safety of Epi-On vs Epi-Off Corneal Cross-Linking in Corneal Ectasia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Clinical ophthalmology (Auckland, N.Z.) · 2025Review
- Transepithelial Accelerated Crosslinking for Progressive Keratoconus: A Critical Analysis of Medium-Term Treatment Outcomes.Clinical ophthalmology (Auckland, N.Z.) · 2024Article
- Review
- Recent advances in medicinal compounds related to corneal crosslinking.Frontiers in pharmacology · 2023Review
- Posterior corneal elevation changes and characteristic analysis 1 year after corneal collagen cross-linking for keratoconus.International ophthalmology · 2022Article
- Topographic Outcomes in Keratoconus Surgery: Epi-on versus Epi-off Iontophoresis Corneal Collagen Cross-Linking.Journal of clinical medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimTo evaluate two different techniques of cross-linking: standard epithelium-off (CXL epi-off) versus transepithelial (CXL epi-on) cross-linking in patient with progressive keratoconus.
methodsForty eyes from 32 patients with progressive keratoconus were prospectively enrolled from June 2014 to June 2015 in this nonblinded, randomized comparative study. Twenty eyes were treated by CXL epi-off and 20 by CLX epi-on, randomly assigned, and followed for 2 years. All patients underwent a complete ophthalmologic testing that included uncorrected and best corrected visual acuity, central and peripheral corneal thickness, corneal astigmatism, simulated maximum, minimum, and average keratometry, corneal confocal microscopy, Schirmer I and break-up time (BUT) tests, and the Ocular Surface Disease Index. Intra- and postoperative complications were recorded. The solution used for CXL epi-off comprised riboflavin 0.1% and dextran 20.0% (Ricrolin), whereas the solution for CXL epi-on (Ricrolin TE) comprised riboflavin 0.1%, dextran 15.0%, trometamol (Tris), and ethylenediaminetetraacetic acid. Ultraviolet-A treatment was performed with a UV-X system at 3 mW/cm
resultsIn both groups, a significant improvement in visual function (Group 1: baseline 0.36 ± 0.16 logMAR, two-year follow-up 0.22 ± 0.17 logMAR,
conclusionOur findings demonstrate that both procedures are able to slow keratoconus progression. Both treatment modalities are equivalent in terms of results and related complications. CXL epi-on technique is preferable to CXL epi-off since it preserves the corneal thickness and improves visual acuity, also reducing the postoperative ocular discomfort during the study period.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.