Corneal Collagen Cross-linking (CXL): Effectiveness and Safety in Progressive Keratoconus in Pediatric Patients with Adequate Corneal Thickness

Abstract

Background: This study was undertaken to evaluate the outcomes of corneal collagen cross-linking for treatment of progressive keratoconus in pediatric patients who had adequate corneal thickness. Material and Methods: About 50 eyes of pediatric age group (<18years) with progressive keratoconus having corneal thickness more than 450 microns were subjected to accelerated corneal collagen cross-linking(CXL). Pre-op parameters were compared with1month, 6 months, 12 months post CXL. Scheimpflug Imaging was used to assess the Maximum keratometry (Kmax), Pachymetry (thinnest), Total corneal irregular astigmatism (RMS).Best Corrected Visual Acuity(BCVA), Spherical Equivalent and Corneal endothelial counts were also assessed. Results: At6 and 12monthsKmaxreduced from pre-op 57.26±4.69D to 57.73±5.06D and 56.34±4.90D (Pvalue<0.05); Pachymetry changed from 466.96±19.59μm to451.44±19.41μmand 449.28±20.75μm(P value <0.05); BCVA was improved from 0.598±0.318 to 0.530 ± 0.292 at 6 months andto 0.488 ± 0.283 at 12 months(P value <0.05). RMS reduced from 1.005±0.473 to 1.04±0.477 and 0.90±0.478 (P value <0.05) at 6 months and 12 months respectively. There was no significant change in spherical equivalent and endothelial count at 1 year of follow up. Conclusion: Corneal Collagen Cross-linking is a safe and effective procedureto freeze keratoconus progression in pediatric eyes.