Background: Keratoconus (KC) normally appears around adolescence, while advanced instances have been documented in youngsters as young as four years old. KC occurs at a greater rate and progresses quicker in juvenile patients than in adults. The advancement of KC may result in visual impairment in young patients, as well as ramifications for the child's social and scholastic development.
Objective: To study the effectiveness of accelerated collagen crosslinking (CXL) in halting the progression of keratoconus in children and adolescents for up to 3 years after treatment.
Patients and Methods: This was a retrospective interventional study. 15 eyes from 9 children and adolescents, who had a confirmed progressive keratoconus, underwent accelerated collagen crosslinking (CXL), and followed up for 3 years for mean keratometric reading (Km), corneal front astigmatism (Astig), pachymetry at pupillary center, Index of surface variance (ISV), and Index of vertical asymmetry (IVA)
Results: Mean logMAR VA significantly improved. No statistically significant change occurred in K mean values from preoperative to postoperative values at years 1-3. Main K-apex decreased significantly from preoperative 54.34 ± 5.31D to 52.34 ± 5.37 at year-1 postoperatively (P = 0.004), 51.24 ±4.51 at year-2 (P = 0.012), 51.13 ± 4.87 at year-3 (P = 0.007). The mean topographic cylinder (Astig) values did not change significantly from preoperative to year-1 (P =0.90) at year-2 (P =0.13) at year-3 (P =0.75). Mean pachymetry value at the center of the cornea significantly changed from preoperative 507.25 to 475.167 at year-1 (P =0.22) and 463.9 at year-2 (P =0.004), but not year-3 (483.67, P=0.18).
Conclusions: The accelerated technique of collagen cross-linking could stop the progression of keratoconus with no serious adverse effects in adolescent cases over a period of 3-years.