Accelerated Corneal Collagen Cross-Linking in Pediatric Keratoconus

Area of Science:

• Ophthalmology
• Corneal Surgery
• Pediatric Eye Care

Background:

• Keratoconus (KCN) is a progressive corneal ectasia that often affects young individuals.
• Early intervention is crucial to prevent vision loss in pediatric patients with KCN.
• Corneal collagen cross-linking (CXL) is a standard treatment to halt KCN progression.

Purpose of the Study:

• To evaluate the visual, refractive, and topographic outcomes of accelerated corneal collagen cross-linking (CXL) in pediatric patients.
• To assess the efficacy and safety of accelerated CXL in halting the progression of keratoconus in individuals aged 18 years or younger.

Main Methods:

• Retrospective case series including 89 eyes of 56 pediatric patients (≤18 years) with progressive KCN.
• All patients underwent accelerated corneal CXL.
• Comprehensive ophthalmic examinations and corneal tomography (Pentacam) were performed pre- and post-operatively.

Main Results:

• Mean best corrected visual acuity (BCVA) improved significantly from 0.26 to 0.16 logMAR (P < 0.001).
• Mean corneal astigmatism decreased from 3.69 to 3.15 diopters (P = 0.016).
• Mean maximum keratometry (Kmax) significantly reduced from 53.23 to 52.23 diopters (P = 0.047).

Conclusions:

• Accelerated CXL is effective in improving visual acuity in pediatric patients with progressive KCN.
• The procedure stabilizes or improves keratometric indices, halting disease progression.
• Accelerated CXL demonstrates a favorable safety profile with no serious complications in this pediatric cohort over a mean follow-up of 16 months.