Transepithelial corneal cross-linking in pediatric patients: early results.
OBJECTIVE
To report 18-month follow-up after transepithelial cross-linking (CXL) in young patients.


METHODS
Thirteen eyes with keratoconus were evaluated (mean patient age: 14.4 ± 3.7 years [range: 8 to 18 years]). Corrected distance visual acuity (CDVA); spherical equivalent refraction; keratometry (K); coma, spherical aberration, and higher order aberrations (HOAs) for a 5.0-mm pupil; and thinnest point were measured preoperatively and 1, 3, 6, 9, 12, and 18 months postoperatively by Scheimplflug camera. Endothelial cell density and anterior segment optical coherence tomography were also evaluated. Paired Student t test was used to compare preoperative and 12- and 18-month postoperative data. P<.05 was considered significant.


RESULTS
Eighteen months after treatment, CDVA improved significantly, whereas K readings and HOAs showed statistically significant worsening (P<.05). Spherical equivalent refraction, sphere and cylinder, coma, spherical aberration, thinnest point, and endothelial cell density did not show statistically significant changes (P>.05). The mean demarcation line depth was 105 μm. No side effects were observed.


CONCLUSIONS
Transepithelial CXL appears to be a safe treatment in children. Although improved CDVA was noted 18 months after treatment, this technique does not effectively halt keratoconus progression in children compared to standard CXL.
Ophthalmology Department, Bambino Gesù Children's Hospital, IRCCS, Rome. lucabuzzonetti@yahoo.it
Luca
L
Buzzonetti
Gianni
G
Petrocelli
D000293:Adolescent; D002452:Cell Count; D002648:Child; D003094:Collagen / Q000378:metabolism; D003319:Corneal Stroma / Q000378:metabolism; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D004728:Endothelium, Corneal / Q000473:pathology; D019573:Epithelium, Corneal / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D012256:Riboflavin / Q000627:therapeutic use; D041623:Tomography, Optical Coherence; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology
D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin