Population Effect of Croslinking Treatment for Keratoconus in a Pediatric Population

Keratoconus is a progressive condition that weakens the cornea and affects vision. Symptoms typically emerge in the second or third decade of life, though rare cases in young children occur. Early diagnosis is crucial to prevent vision deterioration.

The aim of this study was to evaluate the effectiveness of the accelerated crosslinking treatment for keratoconus in the pediatric population.

This prospective study evaluated 20 eyes in 13 patients with keratoconus who underwent accelerated crosslinking procedures at Eye Clinic Svjetlost Sarajevo with a one-year follow-up. Participants aged 12 to 18 had a confirmed keratoconus diagnosis and corneal thickness over 400 microns. Preoperative examinations included visual acuity (LogMAR scale), keratometry measurements, central corneal thickness, and keratoconus grading using the ABCD system on a Pentacam.

Postoperative results showed stability and postoperative improvement of uncorrected and corrected visual acuity (P < 0.001). Postoperative keratometries, specifically Km and Kmax, showed a statistically significant decrease, flattening by approximately 1 diopter (D) and 1.5 diopters (D), respectively. Results of postoperative ABCD score showed stability, without postoperative deviation from the mean value and standard deviation. Central corneal thickness values decreased to 456.48 ± 27.2 μm at the one-year examination, and were statisticaly significant compared to preoperative values (P < 0.001).

Stopping progression with crosslinking is the single most important part of management of the pediatric keratoconus patient, thus early diagnosis is imperative. Crosslinking is a safe procedure and the only treatment for pediatric keratoconus that has been proven to halt the progression of the disease and prevent prolonged reduction in a child's visual acuity.