Accelerated corneal crosslinking for treatment of progressive keratoconus in pediatric patients

Purpose: To evaluate the safety and efficacy of accelerated corneal crosslinking (CXL) in patients with progressive keratoconus aged 18 years or less. Methods: A total of 28 eyes from 19 patients with progressive keratoconus aged 18 years or less were enrolled. We divided participants into 2 groups according to corneal thickness (CT). Group 1 included 13 eyes of 8 patients with CT >= 450 mu m; group 2 included 15 eyes of 11 patients with CT < 450 mu m. Each participant underwent accelerated CXL using 10-minute ultraviolet A irradiance at 9 mW/cm(2) for a total energy dose of 5.4 J/cm(2). The efficacy and safety of the procedure were assessed postoperatively at 1, 3, 6, and 12 months with Pentacam and visual acuity. Results: In uncorrected visual acuity, group 1 showed a statistically significant +0.12 logMAR improvement at 3 months postoperatively (p = 0.003), and in group 2, there was a statistically significant +0.3 logMAR improvement at 1 month postoperatively (p = 0.005). In best-corrected visual acuity, there was a +0.15 logMAR (p<0.001) and +0.22 logMAR (p = 0.005) improvement in group 1 and group 2, respectively, at 12 months postoperatively. All mean keratometric values including K1 and K2 dropped by at least 1 D or remained stable (< +/- 1 D) in both groups after accelerated CXL treatment. Conclusions: The findings showed that accelerated CXL treatment seems to be effective in slowing or halting the progression of keratoconus and that no permanent apparent complications are noted 6 months after accelerated CXL.