Accelerated Corneal Collagen Cross‑Linking in Pediatric Keratoconus

Purpose: To evaluate the visual, refractive, and topographic outcomes of accelerated corneal collagen cross‑linking (CXL) in the pediatric age group. Methods: In this retrospective case series study, 89 eyes of 56 patients with progressive keratoconus (KCN) who were under or equal to 18 years old at the time of surgery were included. All patients underwent accelerated corneal CXL. A thorough baseline and follow‑up ophthalmic examination including uncorrected distance visual acuity, best corrected visual acuity (BCVA), slit‑lamp and fundus examination, and corneal tomography by Scheimpflg camera Pentacam (Oculus, Wetzlar, Germany) were performed. Results: The mean age of patients was 16.2 ± 1.8 years. Mean follow‑up was 16.46 ± 11.6 months (range, 6–40 months). The mean BCVA improved significantly from 0.26 ± 0.26 to 0.16 ± 0.19 (logMAR) after accelerated CXL (P < 0.001). The mean corneal astigmatism based on refraction decreased from 3.69 ± 2.12 to 3.15 ± 1.86 after the intervention (P = 0.016). The mean maximum keratometry (Kmax) reduced significantly from 53.23 ± 6.07 diopter (D) to 52.23 ± 6.33 D (P = 0.047). The mean flat keratometry (K1) reduced from 46.37 ± 3.69 to 45.95 ± 3.65 after the intervention (P = 0.119). Conclusion: Our study shows that accelerated CXL increases visual acuity and stabilizes or improves keratometric indices in pediatric patients with progressive KCN without any serious complication for a mean follow‑up time of 16 months.