LONG TERM OUTCOME OF BILATERAL SIMULTANEOUS ACCELERATED CORNEAL COLLAGEN CROSS LINKING IN PEDIATRIC KERATOCONUS

To study the long‑term clinical outcome of the bilateral simultaneous accelerated corneal collagen cross‑linking (ACXL) procedure in progressive keratoconus in the pediatric population at 2 year follow‑up.

Davangere Netralaya

Retrospective cross‑sectional study that included 39 patients (78 eyes) with progressive pediatric keratoconus treated with epi‑off bilateral ACXL in the same sitting between 2019 and 2023. The change in pre‑operative vs. post‑operative distance‑corrected visual acuity (DCVA), average keratometry, maximum keratometry (Kmax), and thinnest corneal thickness (TCT) values was assessed at the end of 2 years. 

A total of 78 eyes of 39 patients with a mean age of 15.2 ± 1.8 years were taken. At 24 months, there was a significant improvement in the mean DCVA of 0.256 ± 0.319 (P = 0.00001) and 0.239 ± 0.319 logMAR units (P = 0.00001) for the right (RE) and left eye (LE), respectively. The average keratometry (Avg K) decreased significantly from 48.65 ± 5.63 to 47.82 ± 5.43 D (P = 0.00069) and from 49.76 ± 5.17 to 47.7 ± 4.68 D for RE and LE, respectively. Pre‑operative TCT in RE and LE was 445.15 ± 48.49 µm and 444.46 ± 45.81 µm which stabilized post‑operatively in RE at 439.51 ± 47.18 µm and in LE at 434.24 ± 48.24 µm (P = 0.00456). No significant side effects (permanent corneal haze, keratitis, or endothelial damage) were observed.

Bilateral simultaneous ACXL is an effective and safe procedure to improve compliance due to a shorter operative time, especially in the pediatric population.