Accelerated corneal cross-linking in pediatric patients with keratoconus: 24-month outcomes

• Published in: Journal of refractive surgery (1995) Vol. 30; no. 12; p. 843
• Main Authors: Ozgurhan, Engin Bilge, Kara, Necip, Cankaya, Kadir Ilker, Kurt, Tugba, Demirok, Ahmet
• Format: Journal Article
• Language: English
• Published: United States 01-12-2014
• Subjects: Adolescent; Cell Count; Child; Collagen - metabolism; Corneal Stroma - metabolism; Corneal Topography; Corneal Wavefront Aberration - physiopathology; Cross-Linking Reagents - therapeutic use; Endothelium, Corneal - pathology; Female; Follow-Up Studies; Humans; Keratoconus - drug therapy; Keratoconus - metabolism; Keratoconus - physiopathology; Male; Photochemotherapy - methods; Photosensitizing Agents - therapeutic use; Postoperative Complications; Refraction, Ocular - physiology; Retrospective Studies; Riboflavin - therapeutic use; Treatment Outcome; Ultraviolet Rays; Visual Acuity - physiology
• ISSN: 1081-597X
• DOI: 10.3928/1081597X-20141120-01

To compare the efficiency and safety of accelerated corneal cross-linking in pediatric patients with progressive keratoconus.
In this retrospective interventional case series, 44 eyes of 38 pediatric patients with progressive keratoconus were enrolled. All consecutive patients underwent accelerated corneal cross-linking with settings of 30 mW/cm(2) for 4 minutes, corresponding to a total dose of 7.2 J. The efficacy and safety of the procedure were assessed over a 24-month follow-up period.
Mean ± standard deviation age of 10 girls and 28 boys was 15.3 ± 2.1 years (range: 9 to 18 years). Uncorrected distance visual acuity improved significantly from 0.52 ± 0.36 to 0.39 ± 0.26 logMAR (P = .002), and corrected distance visual acuity improved significantly from 0.38 ± 0.24 to 0.30 ± 0.20 logMAR (P < .001). Mean spherical and cylindrical refraction were not significantly altered (P > .001 for both). At the last follow-up visit, the flat keratometry value decreased from baseline from 46.4 ± 3.0 to 46.0 ± 2.9 diopters and the steep keratometry value decreased from 50.6 ± 4.2 to 50.1 ± 4.0 diopters (P < .001 for both). The total higher-order aberrations, coma, and astigmatism II values were also significantly decreased at 24 months after treatment (P < .05 for all). No serious complications were recorded during the follow-up.
The findings revealed that accelerated corneal cross-linking halted the keratoconus progression without relevant side effects in pediatric patients over a 24-month follow-up period. Visual acuity, keratometric values, and corneal aberrations also improved.