Results of Corneal Collagen Cross-Linking in Adolescents with Progressive Keratoconus - A Prospective Study.

PURPOSE: Evaluate the safety and efficacy of epi-off corneal cross-linking (CXL) in adolescents with progressive keratoconus (KC).

SETTING: Private clinical practice DESIGN:: Nonrandomized prospective clinical trial METHODS:: 230 adolescent patients aged 10-19 years old with progressive keratoconus (increasing maximum keratometry (Kmax) or astigmatism of ≥ 1 D associated with decreased corrected distance visual acuity (CDVA)) underwent CXL. Exclusion criteria were age at time of CXL < 10 years or > 19 years, corneas that were thinner than 400 μm or demonstrated central corneal scarring, history of herpetic eye disease, or pregnancy or nursing. Follow up examinations of uncorrected distance visual acuity (UDVA), CDVA, Kmax and minimum pachymetry occurred on 130 eyes at 1 year, 77 eyes at 2 years and 55 eyes at 3 years post-CXL.

RESULTS: UCVA significantly improved from preop to 1, 2 and 3 years post-CXL. CDVA significantly improved from preop to 1, 2 and 3 years post-CXL. Kmax significantly reduced (improved) from preop to 1 and 3 years post-CXL and reduced (improved) (p=0.22) from preop to two years post-CXL. Minimum pachymetry decreased significantly from preop to 1, 2 and 3 years post-CXL.

CONCLUSIONS: CXL in patients aged 10-19 years old is safe and efficacious, halts progression of KC and can improve UCVA, CDVA and Kmax. Minimum pachymetry decreases and stabilizes post-CXL. Ophthalmologists should encourage adolescent patients with KC to obtain prompt evaluation and possible CXL to halt progression of the disease.