Accelerated corneal collagen cross-linking in pediatric keratoconus: One year study.
OBJECTIVE
To evaluate the safety and effectiveness of accelerated corneal collagen crosslinking (CXL) in pediatric keratoconus.


METHODS
Prospective non-randomized observational study.


METHODS
33 eyes of 25 children with keratoconus were included. The corneal epithelium was mechanically removed. Next, riboflavin/hydroxypropyl methylcellulose solution) was applied for 10 min. Accelerated CXL (10 mW/cm2for 9 min), was accomplished. Visual acuity, slit lamp examination, refraction, keratometry readings, pachymetry, anterior and posterior elevations, average progression indices, and Q values were recorded. The follow-up visits were scheduled on one day, 3 days, 7 days, one month and then on 3, 6, 12 months after the procedure.


RESULTS
It was statistically significant improvement of the mean UAVA, AVA, and the mean corneal astigmatism (P< .0001). The mean corneal thickness showed a significant reduction. The preoperative meanKmax reading was reduced from 49.12 ± 3.7 D preoperatively to 47.9 ± 3.7 D at 12 months. The mean max anterior elevation, average progression index and Q value showed statistically significant improvement. No significant impact on posterior elevation was recorded. Serious complications were not encountered in this study.


CONCLUSIONS
Accelerated CXL shows a stabilization and beneficial clinical outcomes in pediatric keratoconus. It seems an effective and safe procedure in this age group. Effects of accelerated CXL on the posterior corneal surface will need further evaluation.
Department of Ophthalmology, Mansoura Ophthalmic Center, Faculty of Medicine, Mansoura University, Egypt.
Amani E
AE
Badawi
Accelerated; Cross-linking; Keratoconus; Pediatric ophthalmology; Posterior corneal elevation