Outcomes of accelerated corneal cross-linking for pediatric and adult keratoconus: a comparative study Academic Article in Scopus uri icon

abstract

  • Purpose: To compare the visual, refractive, and topographic outcomes of a high irradiance accelerated corneal crosslinking (ACXL) protocol after a 12-month follow-up between pediatric and adult patients with progressive keratoconus (KC). Methods: Retrospective, comparative, cohort study. Patients with KC were divided into two groups: pediatric (¿ 18 years) and adult (> 18 years). All of them were managed with epi-OFF ACXL (30 mW/cm2, 8 min, pulsed 1:1 on and off = 7.2 J/cm2). Visual, refractive, and topographic values were measured preoperatively and at 1, 3, 6, and 12 months postoperative. KC progression, defined as a Kmax increase of ¿ 1D during follow-up, was recorded. Results: Eighty-nine eyes (53 patients) were included for analysis; 45 (50.6%) eyes were from pediatric patients and 44 (49.4%) from adults. At one-year follow-up, pediatric patients experienced significantly higher rates of progression (22.2% vs. 4.5%, p =.014). Contrariwise, female gender (Beta = ¿ 3.62, p =.018), a baseline uncorrected visual acuity of Snellen ¿ 20/60 (Beta = ¿ 5.96, p =.007), and being ¿ 15 years at ACXL treatment (Beta = ¿ 0.31, p =.021) were associated with non-progressive disease. A significant improvement in best-corrected visual acuity, Kmin, Km, and Kmax was recorded in both groups. Overall, 86.5% of eyes from both groups showed Kmax stabilization or improvement. Conclusions: Despite the similarity in visual, refractive, and topographic outcomes in both groups, younger age was associated with KC progression after ACXL at one year of follow-up. © The Author(s), under exclusive licence to Springer Nature B.V. 2024.

publication date

  • December 1, 2024