ReviewTaiwan journal of ophthalmology
Short- and long-term safety and efficacy of corneal collagen cross-linking in progressive keratoconus: A systematic review and meta-analysis of randomized controlled trials.
Review in Taiwan journal of ophthalmology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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
11 citing papers in PubMed, 16 citations in OpenAlex.
- Automated Triage for New Keratoconus Referrals Using Multimodal Deep Learning.Ophthalmology science · 2026Article
- Outcome of accelerated corneal cross-linking with 0.25% riboflavin in progressive keratoconus patients.International ophthalmology · 2026Article
- Vision-Related Quality of Life in Iraqi Keratoconus Patients: A Comparative Analysis of Surgical and Nonsurgical Interventions.Korean journal of ophthalmology : KJO · 2026Article
- Evidence-Based Clinical Practice Guideline for Diagnosis, Treatment, and Follow-Up of Keratoconus Patients.Clinical ophthalmology (Auckland, N.Z.) · 2026Review
- The microenvironment of ocular surface in keratoconus: a systematic review.Eye and vision (London, England) · 2025Review
- Six-Month Outcomes of Accelerated Corneal Cross-Linking with a Total Dose of 7.2 J/cm2 Using Dextran-Free Riboflavin.Korean journal of ophthalmology : KJO · 2025Article
- Influence of Crosslinking on Astigmatism Vector in Keratoconus: A Vector Analysis.Ophthalmology and therapy · 2025Article
- Enhanced Riboflavin Stromal Delivery Using Microchannel-Assisted Iontophoresis for Corneal Crosslinking.Translational vision science & technology · 2025Article
- Influencing Factors in Corneal Densitometry Recovery After Accelerated Cross-Linking for Keratoconus.Journal of ophthalmology · 2025Article
- Digital transformation of care for keratoconus patients: ML modeling structural outcomes of corneal collagen cross-linking.Frontiers in medicine · 2025Article
- Corneal Endothelial Microscopy: Does a Manual Recognition of the Endothelial Cells Help the Morphometric Analysis Compared to a Fully Automatic Approach?Vision (Basel, Switzerland) · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 7 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of the study is to evaluate the safety and outcomes of corneal collagen cross-linking (CXL) and different CXL protocols in progressive keratoconus (PK) population at short and long-term. MATERIALS AND
methodsA systematic review and meta-analysis was conducted. A total of eight literature databases were searched (up to February 15, 2022). Randomized controlled trials (RCTs) comparing CXL versus placebo/control or comparing different CXL protocols in the PK population were included. The primary objective was assessment of outcomes of CXL versus placebo and comparison of different CXL protocols in terms of maximum keratometry (Kmax) or Kmax change from baseline (Δ), spherical equivalent, best corrected visual acuity (BCVA), and central corneal thickness (CCT) in both at short term (6 months) and long term (1
resultsA total of 48 RCTs were included. Compared to control, CXL was associated with improvement in Δ Kmax at 1 year (4 RCTs, mean difference [MD], -1.78 [-2.71, -0.86], P = 0.0002) and 2 and 3 years (1 RCT); ΔBCVA at 1 year (7 RCTs, -0.10 [-0.14, -0.06], P < 0.00001); and Δ CCT at 1 year (2 RCTs) and 3 years (1 RCT). Compared to conventional CXL (C-CXL), deterioration in Δ Kmax, ΔBCVA and endothelial cell density was seen at long term in the transepithelial CXL (TE-CXL, chemical enhancer). Up to 2 years, there was no difference between TE-CXL using iontophoresis (T-ionto) and C-CXL. At 2 and 4 years, C-CXL performed better compared to accelerated CXL (A-CXL) in terms of improving Kmax. Although CCT was higher in the A-CXL arm at 2 years, there was no difference at 4 years. While exploring heterogeneity among studies, selection of control eye (fellow eye of the same patient vs. eye of different patient) and baseline difference in Kmax were important sources of heterogeneity.
conclusionCXL outperforms placebo/control in terms of enhancing Kmax and CCT, as well as slowing disease progression over time (till 3 years). T-ionto protocol, on the other hand, performed similarly to C-CXL protocol up to 2 years.
Indexed as
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.