Purpose
To determine the safety and efficacy of corneal collagen cross-linking (CXL) for progressive keratoconus in patients 9 to 14 years old
Methods
Sixteen eyes of eleven patients (8 male and 3 female) with progressive keratoconus, underwent epithelium-off CXL according to the standard Dresden protocol. Mean follow-up was 26 months (range, 12 to 60 months). Pre- and postoperative examinations included: uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), corneal topography, refraction, corneal pachymetry, and endothelium cell count
Results
At the last follow-up visit, BSCVA improved by at least one Snellen line in 4 eyes (25%) and remained stable in 10 eyes (62.5%). Two eyes (12.5%) in habitual eye rubbers, required a re-treatment due to keratoconus progression, 15 and 28 months after first CXL. Manifest refraction and endothelium cell count remained stable. Corneal thickness decreased at the first postoperative month with gradual return to preoperative values. Topographic results showed statistically significant improvement in maximum K readings up to two years after CXL. However, it lost significance over time. No intraoperative complications were observed. Two eyes (12.5%) presented grade one haze, which regressed after a month of topical steroid therapy.<br />
Conclusions
In this study of selected patients 9 to 14 years old, CXL was a safe and effective option for the treatment of progressive keratoconus. However, the effect of arrest of disease progression may not be as long lasting as in adults.<br />