title: One-year clinical study on efficacy of corneal cross-linking in Indian children with progressive keratoconus.
abstract: OBJECTIVE
  The aim of this study was to assess the efficacy of corneal collagen cross-linking (CXL) with riboflavin using ultraviolet-A light in children with progressive keratoconus.
  
  
  METHODS
  Thirty-five eyes of 24 children with progressive keratoconus aged between 9 and 16 years were included in this retrospective study. Ocular examination included the best-corrected visual acuity (BCVA), dilated refraction, slit-lamp exam, and corneal topography (Orbscan II) at 6 and 12 months. All children were treated with riboflavin with ultraviolet-A light under topical anesthesia and all completed 1-year follow-up.
  
  
  RESULTS
  The mean age of the children was 13.65 years (range, 9-16 years). Follow-up was for a period of 1 year. The mean of preoperative keratometry (Kmax) was 55.11 ± 5.34 diopters (D), whereas the mean of postoperative Kmax was reduced to 53.87 ± 4.99 D. The mean preoperative pachymetry was 412.31 ± 36.54 μm, which changed to 361.31 ± 58.04 μm postoperatively. At 1 year, improvement in the BCVA was noted in 18 (51.42%) eyes, stabilization in 12 (34.28%), and worsening in 5 (14.28%) eyes. Overall, the BCVA improved by 1 line, which was statistically significant (P = 0.0368) at the end of 1 year. There was a reduction in both cylindrical and spherical equivalent, of which, the latter was not statistically significant (P = 0.77), whereas the former was of weak statistical significance (P = 0.061). No complications were reported.
  
  
  CONCLUSIONS
  CXL with riboflavin is an effective procedure for children with progressive keratoconus. The results show stabilization, improvement, or both in keratoconus in terms of BCVA and corneal curvature after CXL in most children.
authors: Cornea Clinic, Eye Foundation and Postgraduate Institute of Ophthalmology, Coimbatore, India.
authors: Shreesha
authors: S
authors: Kumar Kodavoor
authors: Altaf Z
authors: AZ
authors: Arsiwala
authors: Dhandapani
authors: D
authors: Ramamurthy
mesh_terms: D000293:Adolescent; D002648:Child; D003094:Collagen / Q000378:metabolism*; D063171:Corneal Pachymetry; D003319:Corneal Stroma / Q000378:metabolism*; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007194:India; D007640:Keratoconus / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D012256:Riboflavin / Q000627:therapeutic use*; D016896:Treatment Outcome; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin