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Beatrice E Frueh, Manfred Imesch, Christoph Tappeiner, Dan Epstein; Long-term (up to 5 years) results of corneal cross-linking in children with progressive keratoconus. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2987.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate outcomes after cross-linking (CXL) for progressive keratoconus (KC) performed in children up to 18 years of age.
Thirty-four eyes of 26 children with progressive KC were treated according to the standard CXL protocol. Examinations (preoperative and at 1, 2, 3, 4, and 5 years) included topography and tomography. Minimal follow-up was 2 years (mean 37.8±12.6 months). Mean age was 14.5±3.6 years (range 4-18 years). Two patients had Down’s syndrome.
CDVA remained unchanged or improved in every eye. Average Ks remained stable (47.7±3.2D preoperatively, 47.0±3.0D at 1 year, 46.7±2.7D at 2 years, and 47.6±3.7D at 3 years). The spherical equivalent refraction did not change significantly (-2.9±4.8D to -3.8±2.6D at 1 year, and to -3.0±3.0D at 3 years). Mean Kmax decreased from 54.3±5.6D preoperatively to 52.4±5.6D at 1 year, 53.3±5.9D at 2 years, and 53.5±7.3D at 3 years, all statistically significant changes. Topographic indices (SAI and SRI) improved slightly, but the improvement was not statistically significant. Pachymetry at the thinnest point decreased significantly (472±44 µm preoperatively, 457±43D µm at 1 year, and 458±40µm at 3 years). Two eyes with very advanced keratoconus and poor vision, required lamellar keratoplasty at 1 year, and were excluded from the analysis.
CXL is extremely effective in arresting KC progression in children.
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