Evidence map›Paper›PMID 41848870›Full record

ReviewDie Ophthalmologie2026

[Corneal crosslinking for keratoconus: real-life data and Committee for Refractive Surgery (KRC) recommendations].

Florian Thomas Steinberg, Simona Schlereth, Johanna Wiedemann, Michael Simon, Björn Bachmann, Claus Cursiefen

Abstract readEnglish AbstractReview
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In one paragraph

Review in Die Ophthalmologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

6 authors.

Florian Thomas SteinbergZentrum für Augenheilkunde, Universitätsklinikum Köln, Köln, Deutschland. florian.steinberg@uk-koeln.de.ORCID http://orcid.org/0000-0002-4019-8686
Simona SchlerethZentrum für Augenheilkunde, Universitätsklinikum Köln, Köln, Deutschland.
Johanna WiedemannZentrum für Augenheilkunde, Universitätsklinikum Köln, Köln, Deutschland.
Michael SimonZentrum für Augenheilkunde, Universitätsklinikum Köln, Köln, Deutschland.
Björn BachmannZentrum für Augenheilkunde, Universitätsklinikum Köln, Köln, Deutschland.
Claus CursiefenZentrum für Augenheilkunde, Universitätsklinikum Köln, Köln, Deutschland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Keratoconus is a chronic corneal ectasia characterized by a progressive course frequently starting in young age, in which in advanced stages often only a corneal transplantation can help to restore vision. Since the early 2000s, crosslinking has been available as a surgical procedure that can halt the progression of keratoconus. Crosslinking is a low-risk procedure with a high chance of success. To ensure that the costs of crosslinking are covered by the statutory health insurance in Germany, medical evidence of progression must be provided. In the assessment of the Federal Joint Committee on the remuneration for crosslinking a progression is defined as an increase in maximum corneal refractive power (Kmax) or astigmatism in subjective refraction by at least 1 dpt or a decrease in the base curve of the best-fitting contact lens by 0.1 mm. Once the indications for crosslinking have been established, various procedures are available. The standard Dresden Protocol has proven to be a safe intervention in several studies and remains the reference standard for crosslinking procedures but it has some limitations with a minimum pachymetry of 400 µm after corneal abrasion and a long procedural duration. Accelerated crosslinking protocols with increased irradiation intensity and a correspondingly reduced irradiation duration have a similar effectiveness with a lower risk profile. Epi-on protocols, which do not involve epithelial abrasion, reduce the risk of bacterial infections but are less effective than epi-off protocols. New protocols focus on controlling the intensity and duration of irradiation based on pachymetry and topography. The sub-400 protocols made possible by this approach show a high reduction in progression with low endothelial damage despite low pachymetry. The criteria of the Committee for Refractive Surgery (KRC) define the specific range of indications for crosslinking of both the Professional Association of Ophthalmologists in Germany (BVA) and the German Society of Ophthalmology (DOG).

Indexed as

Corneal Cross-LinkingCross-Linking ReagentsKeratoconusGermanyHumansPhotosensitizing AgentsRefractive Surgical ProceduresRiboflavinCross-Linking ReagentsPhotosensitizing AgentsRiboflavinCrosslinking protocolsIrradiation intensityProgression criteriaRange of indicationsRemuneration

Identifiers

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

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.