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Corneal cross-linking in patients younger than 18 years old with progressive keratoconus: up to 5 years of follow-up results

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Session Details

Session Title: Cross-Linking

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

Paper Time: 14:56

Venue: Room 4.6

First Author: : L.Or ISRAEL

Co Author(s): :    A. Rozenberg   A. Abulafia   I. Avni   D. Zadok           

Abstract Details


To evaluate the long-term visual, refractive, topographic and safety outcomes of corneal cross-linking (CXL) in the management of progressive keratoconus in patients younger than 18 years old.


Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin, Israel


A retrospective case analysis was performed on 88 eyes of 44 patients 18 years or younger, with progressive keratoconus, who underwent CXL in at least one eye. Follow-up measurements, for the treated and untreated eye-pair, taken up to 5 years after treatment were compared with baseline values. Parameters included uncorrected distance visual acuity (UCDVA), best spectacle-corrected distance visual acuity (BCDVA), manifest refraction, pachymetry and corneal topography.


Mean age of patients was 15.6±2.1 years. For the treated eye, during all years of follow up, UCDVA improved significantly (from 0.83±0.3 to 0.72±0.28 logMAR; p=0.01). BCDVA was improved (from 0.28±0.19 to 0.23±0.15 logMAR; p=0.06). Manifest cylinder showed significant reduction (from 5.8±3.6 to 4.3±2.5 diopter; p=0.006). There was no significant change in max keratometry. Mean keratometry and corneal thickness were reduced significantly (p=0.009, p=0.002, respectively). For the fellow untreated eye - during 5 years of follow-up, UCDVA showed a slight decrease. BCDVA, mean keratometry and max keratometry remained stable. Five patients had very mild corneal haze post CXL.


Our long-term follow-up suggests that CXL seems to be safe and effective in halting the progression of keratoconus in pediatric patients at all 5-year follow-up. According to this study there is no indication to treat the fellow eye even if the treated eye demonstrated progressive keratoconus at baseline.

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