Accelerated Vs. Standard Corneal Cross-Linking In Pediatric Keratoconus: A Systematic Review And Meta-Analyses.

To evaluate and compare the long-term efficacy and safety of accelerated corneal cross-linking (A-CXL) versus standard corneal cross-linking (S-CXL) in the management of progressive keratoconus in patients under 20 years of age. This meta-analysis focuses on visual acuity outcomes, corneal structural stability, and refractive changes to determine whether accelerated protocols offer comparable therapeutic benefits to the standard approach.

A systematic review and meta-analysis of randomized controlled trials (RCTs).

A comprehensive literature search was conducted in PubMed, Embase, Cochrane Library, and Web of Science following PRISMA guidelines. Studies reporting on the efficacy and safety of accelerated corneal cross-linking versus standard corneal cross-linking in keratoconus patients under 20 years of age were included based on predefined eligibility criteria. Data on uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), central corneal thickness (CCT), maximum keratometry (Kmax), and spherical equivalent were extracted. Statistical analyses were performed using a random-effects model, and heterogeneity was assessed via I² statistics. Results were stratified into two postoperative time points: 12 months and 24 months.

A comprehensive literature search was conducted in PubMed, Embase, Cochrane Library and Web of Science following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies reporting on the efficacy and safety of A-CXL vs S-CXL in keratoconus patients under 20 years of age were included based on predefined eligibility criteria. Data on UDVA, CDVA, CCT, Kmax, and spherical equivalent were extracted. Statistical analyses were performed using a random-effects model, and heterogeneity was assessed via I² statistics. Results were stratified into two postoperative time points: 12 months and 24 months.

Accelerated corneal cross-linking and standard corneal cross-linking demonstrate equivalent long-term efficacy and safety in stabilizing keratoconus progression in patients under 20 years of age. No statistically significant differences were observed in visual acuity, corneal thickness, or keratometric stability over a 24-month follow-up period. These findings support the use of accelerated corneal cross-linking as a viable alternative to the standard protocol, offering potential advantages in reducing treatment time without compromising clinical outcomes. Further high-quality studies with extended follow-up are warranted to confirm these results and assess long-term refractive stability.