Collagen Cross-Linking and Keratoconus in Pediatric Patients

Purpose: To evaluate the efficacy of corneal cross-linking on keratoconic eyes in the pediatric age group. Setting: Private laser center, Haifa, Israel, affiliated to Hadassah Hospital, Jerusalem. Methods: This is a retrospective study of 29 eyes of 20 children treated with corneal cross-linking with aim to arrest the progression of keratoconus. We preformed collagen corneal cross-linking using riboflavin 0.1% and UVA irradiation. Followup ranged between 6 and 46 months (mean 25.5 months). Evaluation included uncorrected visual acuity, best spectacle corrected visual acuity, manifest refraction, slit lamp examination and corneal topography. Ocular response analyzer was used to assess the corneal resistance factor, corneal hysteresis and cornea compensated intraocular pressure. Results: The results show improvement in uncorrected visual acuity and best spectacle-corrected visual acuity and reduction in astigmatism. There was no statistically significant change in sphere, keratometry, corneal resistance factor, corneal hysteresis or cornea compensated intraocular pressure. Conclusion: Corneal cross-linking demonstrates efficacy in arresting the progression of keratoconus as well as improving uncorrected and best corrected visual acuity and reducing astigmatism.