Pediatric Corneal Cross linking: Comparison of Visual and Topographic Outcomes Between Conventional and Accelerated Treatment.
PURPOSE To compare visual and topographic outcomes 1 year after conventional (C CXL) vs accelerated corneal cross linking (A CXL) in pediatric keratoconus (KC) DESIGN Comparative, retrospective, consecutive case series. METHODS Patients with topography confirmed, progressive KC and a corneal thickness of =400 mm at the time of surgery were enrolled. Uncorrected (UCVA) and best phoropter corrected visual acuity (BCVA) and normal maximum keratometry reading (Kmax) were measured at study entry and at the 12 month follow up. Treatment failure rate was defined as the percentage of eyes with an increase in Kmax of more than 1.0 diopter during follow up. The adverse event rate was the percentage of eyes with a loss of =2 Snellen lines of BCVA from baseline. This was a single center analysis of 78 eyes of 58 patients that underwent C CXL (39 eyes) and A CXL (39 eyes) No eyes were lost to follow up after 12 months. RESULTS No significant difference between changes in 12 months after as compared to the time before CXL for UCVA (0.01 log MAR; 95% confidence interval 0.14 to 0.15, P .944) BCVA (0.05 log MAR; 95% confidence interval 0.05 to 0.15, P .310) and Kmax 0.77 diopters; 95% confidence interval 2.20 to 0.65, P .282) between the C CXL and A CXL group were observed. Treatment failure rate was observed in 9 of 39 eyes (23.1% in C CXL and in 6 of 39 eyes (15.4% in A CXL (P .389) Adverse events were seen only in 1 eye in the C CXL group. CONCLUSIONS In this retrospective comparison, the accelerated approach was equally as effective as the conventional protocol to treat pediatric keratoconus.
American journal of ophthalmology