SynthesisInternational ophthalmology2025
Corneal biomechanical property changes following corneal collagen cross-linking in keratoconus: a systematic review and meta-regression analysis.
Synthesis in International ophthalmology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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.
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Who cites it
3 citing papers in PubMed.
- Comparison of choroidal biomarkers and scleral thickness in keratoconus in relation to corneal cross-linking.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026Article
- The Critical Role of Oxygen Supplementation in Epithelium-On Corneal Cross-Linking: A Narrative Review.Advances in therapy · 2026Review
- Crosslinking of tarsal collagen as a hypothetical therapy for dry eye disease.Medical hypothesis, discovery & innovation ophthalmology journal · 2025Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo evaluate the changes in corneal biomechanical properties following corneal collagen cross-linking (CXL) in keratoconus patients and determine factors influencing measurement sensitivity through systematic review and meta-regression analysis.
methodsA comprehensive literature search was conducted across PubMed, Scopus, Cochrane Library, and Google Scholar, identifying 8139 records. After duplicate removal and screening, 12 eligible studies (2009-2024) involving various CXL protocols and measurement tools (Corvis ST, Ocular Response Analyzer [ORA], and Ambrsio Relational Thickness [ART]) were included. Risk of bias was assessed using ROBINS-I and the NIH Quality Assessment Tool. Effect sizes were synthesized using random-effects meta-analysis, and heterogeneity was quantified using I
resultsCXL significantly improved corneal biomechanical properties, particularly when assessed with Corvis ST, which detected changes in 75% of studies, compared to 25% using ORA. Dynamic parameters such as V1, V2, and L2 were more sensitive than standard metrics. Meta-regression revealed a significant correlation between corneal stiffness and visual acuity for Corvis ST (p = 0.02 and p = 0.04, respectively), but not for ORA. The pooled effect size for biomechanical change was 0.74 (95% CI 0.59-0.89), reduced to 0.62 after Trim-and-Fill adjustment, suggesting 16.2% potential publication bias. Egger's test confirmed small-study effects (p = 0.024). Heterogeneity was high (I
conclusionsCXL leads to sustained improvements in corneal biomechanical properties in keratoconus patients, with stronger and more consistent detection using dynamic and device-specific metrics, particularly with Corvis ST. While findings support the long-term efficacy of CXL, variability in measurement protocols underscores the need for standardization. Meta-regression confirms the clinical relevance of biomechanical improvements, especially their correlation with visual function.
Indexed as
Identifiers
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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.