Accelerated corneal crosslinking for treatment of progressive keratoconus in pediatric patients

Area of Science:

• Ophthalmology
• Corneal Surgery
• Vision Science

Background:

• Keratoconus is a progressive condition causing thinning and bulging of the cornea.
• Early intervention is crucial to prevent vision loss in pediatric and adolescent patients.
• Accelerated corneal crosslinking (CXL) is a potential treatment to halt disease progression.

Purpose of the Study:

• To assess the safety and efficacy of accelerated corneal crosslinking (CXL) in patients with progressive keratoconus aged 18 years or younger.
• To evaluate visual acuity and corneal topography changes after the procedure.

Main Methods:

• Nineteen patients (28 eyes) with progressive keratoconus (age ≤18) were divided into two groups based on corneal thickness (≥450 µm and <450 µm).
• All participants underwent accelerated CXL using ultraviolet A (UVA) for 10 minutes at 9 mW/cm² (total energy 5.4 J/cm²).
• Efficacy and safety were monitored using Pentacam and visual acuity at 1, 3, 6, and 12 months post-procedure.

Main Results:

• Both groups showed statistically significant improvements in uncorrected and best-corrected visual acuity at various postoperative intervals.
• Mean keratometric values (K1 and K2) decreased by at least 1 D or remained stable in both groups.
• No permanent complications were observed up to 6 months post-accelerated CXL.

Conclusions:

• Accelerated CXL is effective in slowing or halting the progression of keratoconus in patients aged 18 years or less.
• The procedure demonstrates a favorable safety profile with no noted permanent complications within six months.
• This treatment offers a viable option for managing progressive keratoconus in younger individuals.