This prospective longitudinal study examined patients 18 years of age or less with progressive keratoconus, who underwent corneal crosslinking and completed 10 years of follow-up. Crosslinking protocol involved removal of epithelium, 10 minutes of riboflavin soaking, followed by 30 minutes of UV-A irradiation and repeated riboflavin, with UV-A exposure at 3mW/cm2. Sixty-two eyes of 47 patients were included, with mean age of 14 years; 80% of patients were males. Both uncorrected and best-corrected visual acuity showed significant improvement after six months post treatment and stability over 10 year period. Topographically Kmax values showed significant improvement six months after treatment, which remained statistically significant to the eighth year of follow-up. Coma values improved after one month of treatment, maintaining significant long-term improvement. No significant side-effects of crosslinking were recorded; 12.7% of eyes suffered transient haze, 14.2% of eyes showed Kmax progression of more than 1D. 6.3% of eyes needed retreatments due to keratoconus instability with good secondary results. Overall disease progression rate of 20% was observed within the 10-year period; 3.2% of eyes required corneal transplant due to contact lens intolerance rather than progression. This study shows good long-term results of epithelium-off corneal crosslinking in paediatric population.

Corneal collagen cross-linking with riboflavin and ultraviolet a light for pediatric keratoconus: ten-year results.
Mazzotta C, Traversi C, Baiocchi S, et al.
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Magdalena Popiela

Royal Gwent Hospital, Cardiff, UK.

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