Official ESCRS | European Society of Cataract & Refractive Surgeons


Primary outcomes of epithelium-on corneal cross-linking for paediatric keratoconus: a one-year prospective study

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Session Details

Session Title: Presented Poster Session: Corneal Cross-Linking

Venue: Poster Village: Pod 3

First Author: : A.Moradi USA

Co Author(s): :    A. Malik   D. Goodman                    

Abstract Details


To report the 1-year follow-up efficacy and safety of transepithelial cross-linking (CXL) for progressive keratoconus (KC) in pediatric patients.


Prospective, single-center, consecutive case series.


The study included all consecutive pediatric patients (aged 18 years or less) who underwent an epithelium-on CXL procedure for progressive KC from 2012 through 2018. A total of 58 eyes from 31 patients were enrolled for analysis. Uncorrected (UCVA) and best corrected visual acuity (BCVA) and normal maximum keratometry reading (K-max) were measured at study entry and at the follow-up visits. The efficacy and safety of the procedure were assessed postoperatively at 1, 3, 6, and 12 months with Pentacam and visual acuity.


25 patients (80.6%) were males, and mean age at the time of CXL was 15.2±1.9 years (range: 9-18 years). Mean follow-up was  20.74±16.3 months (range, 6-74.4 months). Twelve months after treatment; mean K-max decreased from 54.11±7.99 to 53.76±8.04 (P=0.82), mean UCVA improved from 0.69±0.52 LogMAR to 0.59±0.75 LogMAR (p = 0.42), mean BCVA significantly improved from 0.22±0.26 to 0.11±0.17 LogMAR (p = 0.01), and the manifest cylinder decreased from 3.28±2.29 to 2.71±2.54 (p=0.28). No intra- or postoperative complications were observed.


This study suggests that transepithelial CXL is a safe and effective procedure to slow down KC progression in pediatric patients with significant improvement in the best-corrected visual acuity at 1-year follow-up. The long-term effects need further observation.

Financial Disclosure:

... gains financially from product or procedure presented, ... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented

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