Evidence map›Paper›PMID 40866781›Full record

ArticleOphthalmology and therapy2025

Clinical Outcomes of Repeated Corneal Crosslinking for Progressive Keratoconus After Failure of Primary Procedure; Safety and Efficacy at 12-Month Follow-Up.

Mohamed Elalfy, Eleftherios Chatzimichail, Kareem Mahgoub, Aida Hajjar-Sese, Hasan Naveed, Georgios D Panos, Khaled Abdelhamid, Frank Blaser, Artemis Matsou, Zisis Gatzioufas

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Article in Ophthalmology and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Mohamed Elalfy *Corneoplastic Unit, Queen Victoria Hospital, East Grinstead, UK.
Eleftherios Chatzimichail *Department of Ophthalmology, University Hospital of Basel, 4031, Basel, Switzerland.
Kareem MahgoubCorneoplastic Unit, Queen Victoria Hospital, East Grinstead, UK.
Aida Hajjar-SeseCorneoplastic Unit, Queen Victoria Hospital, East Grinstead, UK.
Hasan NaveedCorneoplastic Unit, Queen Victoria Hospital, East Grinstead, UK.
Georgios D PanosFirst Department of Ophthalmology, School of Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Khaled AbdelhamidDepartment of Ophthalmology, University Hospital of Basel, 4031, Basel, Switzerland.
Frank BlaserDepartment of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Artemis MatsouCorneoplastic Unit, Queen Victoria Hospital, East Grinstead, UK.
Zisis GatzioufasDepartment of Ophthalmology, University Hospital of Basel, 4031, Basel, Switzerland. zisisg@hotmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis study aims to evaluate the efficacy and safety of repeated corneal cross-linking (CXL) in patients with progressive keratoconus who have undergone an unsuccessful primary epithelium-off (epi-off) CXL procedure. Additionally, it compares the keratometric changes between initial and repeated CXL treatments.

methodsIn this multicenter retrospective cohort study, eyes that underwent repeated accelerated epi-off CXL (9 mW/cm

resultsFifty-three eyes from 53 patients were included (26 repeated CXL, 27 control). In the control group, Kmax decreased by a median of 0.90 D (from 56.3 to 55.5 D, p = 0.0092) and the thinnest point increased by a mean of 35 µm (p = 0.001). In the repeated CXL group, Kmax decreased by 0.10 D (from 60.8 to 59.1 D, p = 0.307), and the thinnest point remained stable (436 to 435 µm, p = 0.8728). CDVA did not change significantly in either group. No complications were observed.

conclusionsRepeated accelerated CXL appears to be a safe and effective option for stabilizing keratoconus after failure of the primary procedure. While the corneal flattening effect was milder compared to primary CXL, disease progression was halted in all eyes following retreatment.

Indexed as

FailureKeratoconusRedo corneal collagen cross-linkingRepeated corneal collagen cross-linkingSecondary corneal collagen cross-linkingSuccess rate

Identifiers

PMID40866781
PMCPMC12413346

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