title: Transepithelial corneal collagen crosslinking for progressive keratoconus in a pediatric age group.
abstract: OBJECTIVE
  To evaluate the effectiveness and safety of transepithelial corneal collagen crosslinking (CXL) in children with keratoconus and the refractive changes induced by this treatment.
  
  
  METHODS
  Ophthalmology Department, Ain-Shams University Hospitals, Cairo, Egypt.
  
  
  METHODS
  Prospective comparative case series.
  
  
  METHODS
  Patients younger than 18 years with bilateral keratoconus had transepithelial CXL with the use of transepithelial riboflavin. The other eye was used as a control and was treated conservatively. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and corneal tomography at 12 months were the main outcome measures.
  
  
  RESULTS
  The mean age of the 22 patients (22 eyes) was 15.7 years ± 2.1 (SD). After transepithelial CXL, the improvement in the mean UDVA was statistically significant (from 0.95 ± 0.34 logMAR to 0.68 ± 0.45 logMAR) (P<.05). No eye lost lines of preoperative UDVA; 1 eye lost 1 line of preoperative CDVA. There was no improvement in the control group in UDVA or CDVA (P>.05). The mean simulated keratometry (K) decreased by a mean of 2.03 diopters (D), with mean flattening of the apical K by 2.20 D; both results were statistically significant (P<.05). In the control group, the simulated K increased by a mean of 0.59 D (P>.05), with mean steepening of the apical K by 2.9 D (P<.05). No significant changes occurred in the endothelial cell count in either group.
  
  
  CONCLUSIONS
  Preliminary results of transepithelial CXL in children with keratoconus were encouraging, with no evidence of progression of keratoconus over 12 months.
authors.affiliation: Ophthalmology Department, Ain Shams University, Cairo, Egypt. ab_gab@hotmail.com
authors.forename: Abdelrahman G
authors.initials: AG
authors.lastname: Salman
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D003094:Collagen / Q000378:metabolism*; D063171:Corneal Pachymetry; D003319:Corneal Stroma / Q000378:metabolism*; D019781:Corneal Topography; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D018450:Disease Progression; D019573:Epithelium, Corneal / Q000187:drug effects; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D017060:Patient Satisfaction; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011379:Prognosis; D011446:Prospective Studies; D012256:Riboflavin / Q000627:therapeutic use*; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin