Observational studyClinical & experimental ophthalmology2023
Five-year corneal cross-linking outcomes: A Save Sight Keratoconus Registry Study.
Observational study in Clinical & experimental ophthalmology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 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
14 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Association Between Keratoconus and Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.Cornea · 2026Pooled it
- Pulsed corneal crosslinking in the treatment of Keratoconus: a systematic review and meta-analysis.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2025Pooled it
- 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
- Adaptive Temporal Mixture of Experts for Predicting Stiffness Metrics From the Ocular Response Analyzer and Identifying Keratoconus.American journal of ophthalmology · 2026Observational
- Trends in the Management of Keratoconus in Australia.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2026Article
- Clinical Experience with Scleral Lens Wear After Corneal Cross-Linking in Keratoconus: Longitudinal Keratometric Outcomes.Journal of clinical medicine · 2026Article
- Review
- Visual Recovery with Cryopreserved Amniotic Membrane After Epi-Off Corneal Cross-Linking in Keratoconus Patients: A Non-Randomized, Controlled, Retrospective Study.Clinical ophthalmology (Auckland, N.Z.) · 2026Article
- Article
- Evaluating corneal cross-linking using Stress-Strain Index maps: a finite element study.Journal of the Royal Society, Interface · 2025Article
- Effects and safety of combined corneal collagen crosslinking and intrastromal corneal ring segment treatment in patients with keratoconus: a retrospective study.BMC ophthalmology · 2024Article
- Five-year results of iontophoresis-assisted transepithelial corneal cross-linking for keratoconus.International ophthalmology · 2023Article
- Five-year corneal cross-linking outcomes: A Save Sight Keratoconus Registry Study.Clinical & experimental ophthalmology · 2023Observational
- Updates on Corneal Collagen Cross-Linking for Keratoconus: A 10-Year Review of Techniques, Clinical Outcomes, and Future Directions.Romanian journal of ophthalmologyReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundWe aimed to determine the long-term outcomes of epithelium-off cross-linking (CXL) in keratoconus patients.
methodsAn observational registry study from 41 centres across 5 countries was carried out. Primary outcomes included the mean change in visual acuity (VA), Kmax, K2, and thinnest corneal thickness (TCT) at 1-5 years. Secondary outcomes included the percentage of eyes with worsening, stable and improving outcomes.
resultsThere were 976 eyes of 794 patients with 1-year of complete follow-up, 501 eyes with 2-years, 355 with 3-years, 235 with 4-years and 162 with 5-years. There was a significant improvement in mean VA from baseline by 3.7 logMAR letters (p < 0.001) in year 1, and 6.9 (p < 0.001) in year 5. Mean Kmax decreased by 1.2 dioptres (D; p < 0.01) in year 1. During subsequent years the Kmax flattening appeared sustained but this was not statistically significant. K2 flattened significantly from baseline in year 1 and then remained stable. At 1 year, 4.1% patients were poor responders to CXL in terms of VA, losing ≥15 letters. The proportion of the poor responders remained unchanged: 4.9% at 5-years. The proportion of poor responders in terms of Kmax remained similar: 5.9% steepening by ≥2D at 1-year and 7.5% at 5-years. The proportion of K2 poor responders remained stable with 4.7% steepening by ≥2D at 1-year and 5.8% at 5-years.
conclusionsCross-linking is effective at stabilising keratoconus up to 5 years in most patients. However, a small proportion of eyes failed to stabilise and had reduced vision.
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