Purpose:
To evaluate outcomes after cross-linking (CXL) for progressive keratoconus (KC) performed in children up to 18 years of age.
Methods:
Twenty-nine eyes of 23 children with progressive KC were treated according to the standard CXL protocol. Examinations (preoperative and at 1,4, 12, 24, and 36 months) included topography and tomography. Minimal follow-up was 12 months (mean 20.7 months). Mean age was 14.8 years (range 4-18 years). Two patients had Down’s syndrome.
Results:
BSCVA remained unchanged or improved in every eye. Average Ks remained stable (47.5± 3.7D preoperatively, 47.6±3.6D at 12 months, and 47.8±2.7D at 24 months), the spherical equivalent refraction decreased from -4.4± 5.4D to -3.1 ± 2.8D at 12 months (p=0.0037). Mean Kmax decreased significantly from 55±7.4D preoperatively to 54.3±10.2D at 12 months and 53.7±3.1D at 24 months. Topographic indices (SAI and SRI) improved slightly, but the improvement was not statistically significant. Pachymetry at the thinnest point decreased in the first months but stabilized by 12 months (472±24 µm preoperatively and 460±48D µm at 12 months). Two cases developed sterile infiltrates. There were no other adverse reactions. Lamellar keratoplasty was eventually performed at 12 months in a very advanced case.
Conclusions:
CXL is very effective in arresting KC progression in children.
Keywords: keratoconus • cornea: clinical science