Accelerated Corneal Cross-linking in Pediatric Patients with Progressive Keratoconus: 12-Month Follow-up Results

<bold>Purpose: </bold>To evaluate effectiveness and safety of accelerated corneal cross-linking (CXL) in the treatment of keratoconus in pediatric patients. <bold>Setting: </bold>Tertiary care hospital. <bold>Design: </bold>Retrospective observational study. <bold>Methods: </bold>In this study, case series of patients 18 years old or younger with progressive keratoconus who underwent accelerated CXL were observed. All consecutive patients underwent accelerated CXL with setting of 9 mW/cm2 for 10-minute Ultraviolet-A radiation, corresponding to a total dose of 5.4 J/cm2. Preoperative and 12-month postoperative data including uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (BDVA), keratometry (K) measurements, mean spherical, and cylindrical refraction were evaluated. <bold>Results: </bold>The group consisted of 28 eyes from 14 patients (10 males and 4 females). Mean age of the patients was 16.9 years (11-18 years). UDVA did not change significantly from 0.71 +/- 0.54 to 0.65 +/- 0.43 logMAR (P = 0.41). BDVA improved significantly from 0.30 +/- 0.35 to 0.21 +/- 0.34 (P = 0.006). The steep K-value decreased from 48.4 +/- 4.3 to 48.0 +/- 4.6 diopters, but there was no significant change in steep K-value (P = 0.35). There was no significant change in flat and mean K-value (P > 0.05). Mean spherical and cylindrical refraction were not significantly altered (P > 0.05). One patient with vernal keratoconjunctivitis showed sterile peripheral corneal infiltrates. Patient was treated with topical corticosteroids, antibiotics, and artificial tears. <bold>Conclusion: </bold>The findings revealed that accelerated CXL is an effective and safe procedure that halts the progression of keratoconus in pediatric patients.