Outcomes of accelerated collagen cross linking in progressive paediatric keratoconus

Indian J Ophthalmol. 2023 May;71(5):1889-1893. doi: 10.4103/ijo.IJO_1469_22.

Abstract

Purpose: To determine the efficacy and safety of pediatric accelerated cross linking (CXL).

Methods: A prospective study on progressive keratoconus (KC) cases under ≤18 years of age. Sixty four eyes of thirty nine cases underwent epithelium-off accelerated CXL protocol. Visual acuity (VA), slit-lamp examination, refraction, pentacam reading of keratometry (K), corneal thickness, and thinnest location pachymetry were noted. Cases were followed up on days 1, 5, and at 1st, 3rd, 6th, and 12th-month post procedure.

Results: Statistically, significant improvement of the mean aided VA, K, and mean corneal astigmatism (p < 0.0001) was noted. Mean Kmax reading reduced from 55.5 ± 5.64 (47.4-70.4) diopter (D) preoperatively to 54.41 ± 5.51 (46-68.3) D at 12 months postaccelerated CXL. Two cases had progression. Complications encountered were sterile infiltrate and persistent haze.

Conclusion: Accelerated CXL is effective and efficacious in pediatric KC.

Keywords: Accelerated collagen cross linking; pediatric keratoconus; pentacam.

MeSH terms

  • Child
  • Collagen / therapeutic use
  • Corneal Topography
  • Cross-Linking Reagents / therapeutic use
  • Follow-Up Studies
  • Humans
  • Keratoconus* / diagnosis
  • Keratoconus* / drug therapy
  • Photochemotherapy* / methods
  • Photosensitizing Agents / therapeutic use
  • Prospective Studies
  • Riboflavin / therapeutic use
  • Ultraviolet Rays

Substances

  • Photosensitizing Agents
  • Riboflavin
  • Cross-Linking Reagents
  • Collagen