title: Outcome of corneal collagen crosslinking for progressive keratoconus in paediatric patients.
abstract: OBJECTIVE
  To evaluate the efficacy of corneal collagen crosslinking for progressive keratoconus in paediatric patients.
  
  
  METHODS
  This prospective study included 25 eyes of 18 patients (aged 18 years or younger) who underwent collagen crosslinking performed using riboflavin and ultraviolet-A irradiation (370 nm, 3 mW/cm2, 30 min).
  
  
  RESULTS
  The mean patient age was 14.3±2.4 years (range 8-17) and mean followup duration was 20.1±14.25 months (range 6-48). Crosslinked eyes demonstrated a significant reduction of keratometry values. The mean baseline simulated keratometry values were 46.34 dioptres (D) in the flattest meridian and 50.06 D in the steepest meridian. At 20 months after crosslinking, the values were 45.67 D (P=0.03) and 49.34 D (P=0.005), respectively. The best spectacle corrected visual acuity (BSCVA) and topometric astigmatism improved after crosslinking. Mean logarithm of the minimum angle of resolution (logMAR) BSCVA decreased from 0.24 to 0.21 (P=0.89) and topometric astigmatism reduced from mean 3.50 D to 3.25 D (P=0.51).
  
  
  CONCLUSIONS
  Collagen crosslinking using riboflavin and ultraviolet-A is an effective treatment option for progressive keratoconus in paediatric patients. Crosslinking stabilises the condition and, thus, reduces the need for corneal grafting in these young patients.
authors.affiliation: Australian School of Advanced Medicine, Macquarie University, Sydney, NSW 2109, Australia.
authors.forename: Deepa
authors.identifier: 0000-0003-2089-8164
authors.initials: D
authors.lastname: Viswanathan
authors.affiliation: Australian School of Advanced Medicine, Macquarie University, Sydney, NSW 2109, Australia ; Sydney Adventist Hospital Clinical School, The University of Sydney, Sydney, NSW 2076, Australia.
authors.forename: Nikhil L
authors.initials: NL
authors.lastname: Kumar
authors.affiliation: Australian School of Advanced Medicine, Macquarie University, Sydney, NSW 2109, Australia ; Sydney Eye Hospital, The University of Sydney, Sydney, NSW 2000, Australia.
authors.forename: John J
authors.initials: JJ
authors.lastname: Males
mesh_terms: D000293:Adolescent; D002648:Child; D003094:Collagen / Q000378:metabolism*; D003315:Cornea / Q000187:drug effects* / Q000473:pathology / Q000528:radiation effects; D003432:Cross-Linking Reagents / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D012256:Riboflavin / Q000008:administration & dosage*; D016896:Treatment Outcome; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000187:drug effects / Q000528:radiation effects
chemical_list: D003432:Cross-Linking Reagents; D003094:Collagen; D012256:Riboflavin