Visual, Topographic, and Pachymetric Effects of Pediatric Corneal Collagen Cross-linking

Purpose: To evaluate the effects of pediatric corneal collagen cross-linking (CXL) on corrected distance visual acuity (CDVA), maximum keratometry (Kmax), and other Scheimpflug imaging system parameters during 2 years of follow-up. Methods: The records of 29 eyes of 29 pediatric patients who underwent unilateral CXL treatment for progressive keratoconus were reviewed. Changes in CDVA, Kmax, anterior chamber depth, anterior chamber volume, anterior chamber angle, pupil-center pachymetry, apical pachymetry, thinnest pachymetry, corneal volume, and topographic indices (index of surface variance [ISV], index of vertical asymmetry [IVA], index of height asymmetry [IHA], keratoconus index [KI], center keratoconus index [CKI], index of height decentration [IHD], and minimum radius of curvature [Rmin]) were analyzed among baseline and 1 and 2 years after the CXL treatment. Results: Mean CDVA and Kmax significantly improved from baseline at 1 year (−0.17 logMAR, P < .0001; −1.18 diopters [D], P = .012, respectively) and 2 years (−0.21 logMAR, P < .0001; −1.40 D, P = .001, respectively) after the CXL treatment. Anterior chamber parameters, corneal thicknesses, and corneal volume remained unchanged during the period following CXL ( P > .05). Five of the seven Scheimpflug topographic indices (including ISV, KI, CKI, IHD, and Rmin) showed significant improvement after CXL between baseline and 2 years ( P < .05). Conclusions: In pediatric patients with progressive keratoconus, CXL appears to be effective in improving CDVA, Kmax, and corneal topographic irregularity at 2 years' follow-up. However, long-term effects of CXL should be tested by further studies in pediatric keratoconus. [ J Pediatr Ophthalmol Strabismus. 2017;54(2):84–89.]