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Andres Codriansky, Maria Carolina Aravena, Marcelo Coria; Shorter UVA Light Exposure Protocol for Crosslinking in Keratoconus in Children Without Progression Criteria. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5279. doi: https://doi.org/.
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To report the safety and efficacy of a shorter UVA light exposure crosslinking treatment Protocol in children with keratoconus without progression criteria.
Case series of patients with keratoconus who were assumed to be progressive based on age of presentation. Patients were treated with crosslinking procedure as follows: 7mm central epithelium mechanical debridement, instillation of isotonic riboflavin 0,1% with dextran 20% solution every 3 minutes for 30 minutes, verification of riboflavin in the anterior chamber was performed with a slit lamp microscope, then exposure to 3mw/cm2 UVA Light for 20 minutes while instilling riboflavin drops every 3 minutes. Patients were patched and seen the day after, at day 3, 7, 30, 3- 6 months, at one year and then accordingly to the physician criteria. Clinical charts were review in a retrospective manner.
10 eyes of 7 patients, 1 woman, 6 men, mean age 15,8 years, (range12 to 18), mean follow up 18,9 months (range: 9 to 33 months). No adverse events nor drop in best corrected visual acuity were reported. Topography remained stable, with a mean flattening of the steepest Keratometry of 0,12 D and a mean steepening of the mean K of 0,2D. There were 3 cases of treatment failure, defined as steepening on the mean Keratometry of 1D or more during follow up.
Shorter UVA light exposure protocol seems to be safe in Children who were assumed to be progressing. However, it might not be as effective as the standard 30 minute protocol, since we had a 30% failure rate in this group of patients. A randomize, prospective, clinical trial with more patients is necessary to draw more definitive conclusions.
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