title: Accelerated corneal collagen cross-linking in pediatric patients: two-year follow-up results.
abstract: OBJECTIVE
  To evaluate the effectiveness and safety of accelerated corneal collagen cross-linking (ACXL) in patients below 14 years of age with progressive keratoconus.
  
  
  METHODS
  Thirty eyes of 18 patients with established progressive keratoconus underwent preoperative and postoperative visual acuity assessment, topography, and specular microscopy prior to ACXL and were followed up for 24 months.
  
  
  RESULTS
  Mean age of the patients was 12.7 years with ten males and eight females. There was an improvement in the mean postoperative uncorrected distant visual acuity (from 0.76±0.26 to 0.61±0.25; P=0.005), mean corrected distant visual acuity (from 0.24±0.19 to 0.12±0.12; P<0.001), mean spherical refraction (from -3.04 DS±3.60 to -2.38 DS±3.37; P=0.28), mean cylinder (from -3.63 DC±1.82 to -2.80 DC±1.48; P=0.008), and spherical equivalent (from -4.70 D±3.86 to -3.75 D±3.49; P=0.15). Three eyes of two patients with vernal keratoconjunctivitis (VKC) showed progression. There were no intra- or postoperative complications.
  
  
  CONCLUSIONS
  In pediatric patients ACXL is an effective and safe procedure for the management of keratoconus. Optimal management of VKC is important to arrest the progression of keratoconus.
authors.affiliation: Narayana Nethralaya Eye Hospital, 121/C Chord Road, 1 "R" Block, Rajajinagar, Bangalore, Karnataka 560 010, India.
authors.forename: Rohit
authors.initials: R
authors.lastname: Shetty
authors.affiliation: Narayana Nethralaya Eye Hospital, 121/C Chord Road, 1 "R" Block, Rajajinagar, Bangalore, Karnataka 560 010, India.
authors.forename: Harsha
authors.initials: H
authors.lastname: Nagaraja
authors.affiliation: Narayana Nethralaya Eye Hospital, 121/C Chord Road, 1 "R" Block, Rajajinagar, Bangalore, Karnataka 560 010, India.
authors.forename: Chaitra
authors.initials: C
authors.lastname: Jayadev
authors.affiliation: Narayana Nethralaya Eye Hospital, 121/C Chord Road, 1 "R" Block, Rajajinagar, Bangalore, Karnataka 560 010, India.
authors.forename: Natasha Kishore
authors.initials: NK
authors.lastname: Pahuja
authors.affiliation: Narayana Nethralaya Eye Hospital, 121/C Chord Road, 1 "R" Block, Rajajinagar, Bangalore, Karnataka 560 010, India.
authors.forename: Mathew
authors.initials: M
authors.lastname: Kurian Kummelil
authors.affiliation: University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Rudy M M A
authors.initials: RM
authors.lastname: Nuijts
mesh_terms: D000293:Adolescent; D002648:Child; D003094:Collagen / Q000378:metabolism*; D003315:Cornea / Q000187:drug effects* / Q000473:pathology / Q000528:radiation effects*; D019781:Corneal Topography; D003432:Cross-Linking Reagents / Q000528:radiation effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000473:pathology / Q000628:therapy*; D008297:Male; D017319:Photosensitizing Agents / Q000627:therapeutic use; D012256:Riboflavin / Q000008:administration & dosage; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000187:drug effects / Q000528:radiation effects
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin