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Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
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Accelerated corneal cross-linking in pediatric patients with keratoconus: 24-month outcomes
Insights
Accelerated corneal cross-linking effectively halted progressive keratoconus in pediatric patients. This safe treatment improved vision and reduced corneal irregularities over 24 months.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Pediatric Eye Care
Background:
- Keratoconus is a progressive corneal ectasia affecting pediatric patients.
- Early intervention is crucial to prevent vision loss.
Purpose of the Study:
- To evaluate the efficacy and safety of accelerated corneal cross-linking (accelerated CXL) in children with progressive keratoconus.
- To assess visual acuity, refractive error, and corneal topography changes post-procedure.
Main Methods:
- Retrospective analysis of 44 eyes from 38 pediatric patients undergoing accelerated CXL.
- Treatment involved 30 mW/cm² for 4 minutes (7.2 J total dose).
- Follow-up was conducted over 24 months.
Main Results:
- Significant improvement in uncorrected and corrected distance visual acuity (P < .001).
- Reduction in flat and steep keratometry values (P < .001).
- Decrease in higher-order aberrations, coma, and astigmatism II (P < .05).
Conclusions:
- Accelerated CXL is a safe and effective treatment for halting keratoconus progression in pediatric patients.
- The procedure leads to significant improvements in visual function and corneal shape.
- No serious complications were observed during the 24-month follow-up.
Purpose:
To compare the efficiency and safety of accelerated corneal cross-linking in pediatric patients with progressive keratoconus.
Methods:
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.
Results:
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.
Conclusions:
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.
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