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Accelerated corneal cross-linking in pediatric patients with keratoconus: one-year outcomes

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Session Details

Session Title: Cross-Linking

Session Date/Time: Tuesday 10/10/2017 | 14:00-16:30

Paper Time: 14:12

Venue: Room 4.6

First Author: : Sanctis ITALY

Co Author(s): :    P. Marolo   L. Dallorto   L. de Sanctis   R. Penna           

Abstract Details


Purpose. Efficacy of accelerated corneal cross-linking (A-CXL) in halting keratoconus progression in patients under 18 years of age.


Setting. Eye Clinic – University of Turin.


This prospective interventional case series included 30 eyes of 25 consecutive patients (mean age 16.1 years) with progressive keratoconus who underwent epithelium off A-CXL using ultraviolet A light at 10 mW/cm2 for 9 minutes. Disease progression was documented in the last 12 months by an increase in mean keratometry (Km) >0.39 diopters (D) (Pentacam HR, Oculus, Germany) and/or a decrease in central corneal thickness (CTT) >5% (RTVue100, Optovue, USA). Main outcome measures were proportion of eyes with keratoconus progression, Km, CCT, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA) and endothelial cell density (ECD) one year after treatment.


Keratoconus proggression was observed in 4 eyes (13.3%) due to a decrease of CCT >5% in two eyes, an increase of Km >0.39D in one eye and a worsening of both parameters in one eye. Mean Km decreased from 45.50 ±2.10 D to 45.26 ±2.05 D (p=0.03) and CCT from 493.60 ±40.24 µm to 482.87 ±44.89 µm (p<0.001). UDVA improved from 0.35 ±0.20 to 0.40 ±0.21 (p=0.02) and CDVA from 0.68 ±0.20 to 0.76 ±0.19 (p=0.004). Endothelial cell density (ECD) did not change significantly (p=0.88).


A-CXL with ultraviolet A light at 10 mW/cm2 is an effective procedure to halt keratoconus progression in pediatric patients. At the one-year follow-up examination, no progression of disease was noted in 86.7% of cases. However, further studies are required to verify the long-lasting efficacy of this procedure.

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