title: Accelerated corneal crosslinking for treatment of progressive keratoconus in pediatric patients.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of accelerated corneal crosslinking (CXL) in patients with progressive keratoconus aged 18 years or less.
  
  
  METHODS
  A total of 28 eyes from 19 patients with progressive keratoconus aged 18 years or less were enrolled. We divided participants into 2 groups according to corneal thickness (CT). Group 1 included 13 eyes of 8 patients with CT ≥450 µm; group 2 included 15 eyes of 11 patients with CT <450 µm. Each participant underwent accelerated CXL using 10-minute ultraviolet A irradiance at 9 mW/cm2 for a total energy dose of 5.4 J/cm2. The efficacy and safety of the procedure were assessed postoperatively at 1, 3, 6, and 12 months with Pentacam and visual acuity.
  
  
  RESULTS
  In uncorrected visual acuity, group 1 showed a statistically significant +0.12 logMAR improvement at 3 months postoperatively (p = 0.003), and in group 2, there was a statistically significant +0.3 logMAR improvement at 1 month postoperatively (p = 0.005). In best-corrected visual acuity, there was a +0.15 logMAR (p<0.001) and +0.22 logMAR (p = 0.005) improvement in group 1 and group 2, respectively, at 12 months postoperatively. All mean keratometric values including K1 and K2 dropped by at least 1 D or remained stable (< ± 1 D) in both groups after accelerated CXL treatment.
  
  
  CONCLUSIONS
  The findings showed that accelerated CXL treatment seems to be effective in slowing or halting the progression of keratoconus and that no permanent apparent complications are noted 6 months after accelerated CXL.
authors.affiliation:  Department of Ophthalmology, Kayseri Education and Research Hospital, Kayseri - Turkey.
authors.forename: Döndü M
authors.initials: DM
authors.lastname: Ulusoy
authors.affiliation:  Department of Ophthalmology, Kayseri Education and Research Hospital, Kayseri - Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Göktaş
authors.affiliation:  Department of Ophthalmology, Kayseri Education and Research Hospital, Kayseri - Turkey.
authors.forename: Necati
authors.initials: N
authors.lastname: Duru
authors.affiliation:  Department of Ophthalmology, Kayseri Education and Research Hospital, Kayseri - Turkey.
authors.forename: Ayşe
authors.initials: A
authors.lastname: Özköse
authors.affiliation:  Department of Ophthalmology, Kayseri Education and Research Hospital, Kayseri - Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ataş
authors.affiliation:  Department of Ophthalmology, Kayseri Education and Research Hospital, Kayseri - Turkey.
authors.forename: İsa
authors.initials: İ
authors.lastname: Yuvacı
authors.affiliation:  Department of Ophthalmology, Kayseri Education and Research Hospital, Kayseri - Turkey.
authors.forename: Hasan B
authors.initials: HB
authors.lastname: Arifoğlu
authors.affiliation:  Department of Biostatistics, Erciyes University, Kayseri - Turkey.
authors.forename: Gökmen
authors.initials: G
authors.lastname: Zararsız
mesh_terms: D000293:Adolescent; D002648:Child; D003094:Collagen / Q000627:therapeutic use*; D019781:Corneal Topography; D016039:Corneal Transplantation / Q000379:methods*; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000473:pathology / Q000628:therapy*; D008297:Male; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen