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Table 3 Mean differences in the main outcomes and adverse events in non-randomized studies of interventions after corneal collagen cross-linking (epi-on vs. epi-off)

From: Corneal collagen cross-linking epithelium-on vs. epithelium-off: a systematic review and meta-analysis

Study or subgroup Epi-off CXL Epi-on CXL
Mean ± SD n (%) n Mean ± SD n (%) n
Kmax (D)
 Vinciguerra et al. 2019a [47] − 0.1 ± 4.6 20 − 0.4 ± 4.4 20
 Jouve et al. 2017b [52] − 1.1 ± 4.2 40 0.2 ± 5.2 40
 Henriquez et al. 2017a [53] − 0.9 ± 5.2 25 0.1 ± 5.3 36
 Eraslan et al. 2017a [55] − 1.4 ± 2.6 18 − 0.6 ± 3.1 18
 Vinciguerra et al. 2016a [57] − 1.0 ± 1.5 20 − 0.3 ± 1.9 20
UDVA (logMAR)
 Rossi et al. 2018 [51] − 0.1 ± 0.2 10 − 0.2 ± 0.2* 10*
− 0.1 ± 0.2Þ 10Þ
 Henriquez et al. 2017 [53] − 0.1 ± 0.4 25 − 0.1 ± 0.2 36
 Eraslan et al. 2017 [55] − 0.0 ± 0.1 18 − 0.1 ± 0.2 18
CDVA (logMAR)
 Vinciguerra et al. 2019 [47] − 0.1 ± 0.1 20 − 0.1 ± 0.2 20
 Rossi et al. 2018 [51] − 0.1 ± 0.1 10 − 0.1 ± 0.0* 10*
− 0.1 ± 0.1 Þ 10Þ
 Jouve et al. 2017 [52] − 0.1 ± 0.1 40 − 0.1 ± 0.2 40
 Henriquez et al. 2017 [53] − 0.1 ± 0.1 25 − 0.1 ± 0.1 36
 Eraslan et al. 2017 [55] − 0.1 ± 0.1 18 − 0.1 ± 0.1 18
 Vinciguerra et al. 2016 [57] − 0.0 ± 0.1 20 − 0.1 ± 0.1 20
Higher Order Aberrations (µm)
 Vinciguerra et al. 2019 [47] − 0.1 ± 0.3 20 − 0.7 ± 0.2 20
 Vinciguerra et al. 2016 [57] − 0.0 ± 0.2 20 − 0.3 ± 0.8 20
 Comatic Aberrations
 Vinciguerra et al. 2019 [47] − 0.3 ± 1.0 20 1.7 ± 0.3 20
 Rossi et al. 2018 [51] − 0.4 ± 1.2 10 − 0.7 ± 1.4* 10*
− 0.7 ± 1.3 Þ 10Þ
 Eraslan et al. 2017 [55] − 0.2 ± 0.3 18 − 0.1 ± 0.5 18
 Vinciguerra et al. 2016 [57] − 0.2 ± 0.3 20 − 1.2 ± 1.6 20
Demarcation Line (depth in µm at 1 month)
 Jouve et al. 2017 [52] 291.0 ± 61.0 40 216.0 ± 49.0 40
 Eraslan et al. 2017 [55] 272.3 ± 28.6 18 136.6 ± 17.9 18
 Central corneal thickness (µm)
 Rossi et al. 2018 [51] − 2.9 ± 18.9 10 − 1.6 ± 35.5* 10*
− 4.7 ± 30.2 Þ 10Þ
Corneal Thinnest Point (µm)
 Vinciguerra et al. 2019 [47] − 57.0 ± 103.0 20 5.0 ± 38.0 20
 Henriquez et al. 2017 [53] − 12.5 ± 40.2 25 1.5 ± 51.5 36
 Eraslan et al. 2017 [55] − 11.3 ± 14.9 18 − 8.8 ± 14.8 18
 Vinciguerra et al. 2016 [57] − 41.1 ± 35.3 20 1.0 ± 7.2 20
ECD (cells/mm2)
 Rossi et al. 2018 [51] − 32.7 ± 99.3 10 − 46.1 ± 197.9* 10*
− 27.0 ± 62.5Þ 10Þ
KC progression
 Jouve et al. 2017 [52] 3 (7.5%) 40 8 (20.0%) 40
 Henriquez et al. 2017 [53] 3 (12.0%) 25 2 (5.6%) 36
Lost ≥ 2 lines CDVA
 Eraslan et al. 2017 [55] 0 (0.0%) 18 1 (5.6%) 18
Persistent stromal haze
 Henriquez et al. 2017 [53] 1 (0.1%) 25 0 (0.0%) 36
 Eraslan et al. 2017 [55] 5 (27.8%) 18 0 (0.0%) 18
 Sterile infiltrates
 Henriquez et al. 2017 [53] 1 (0.1%) 25 0 (0.0%) 36
  1. CXL = corneal collagen cross-linking; CDVA = corrected distance visual acuity; D = diopter; ECD endothelial cell density; KC = keratoconus; Kmax = maximum keratometry; logMAR = logarithm of the minimum angle of resolution; n (%)= absolute frequency (relative frequency); SD = standard deviation; UDVA = uncorrected distance visual acuity
  2. *Transepithelial CXL treatment study group
  3. ÞIontophoresis CXL treatment study group
  4. aScheimpflug imaging analysis (Oculus Pentacam GmbH, Wetzlar, Germany)
  5. bScanning slit technique (Orbscan IIz; Bausch & LombSurgical, Rochester, NY)