Evaluation of 60 months long-term results of accelerated corneal cross-linking treatment in pediatric keratoconus patients with new progression indices.

Abstract

Purpose: To investigate the long-term efficacy of accelerated corneal cross-linking (CXL) with Belin ABCD progression display in pediatric keratoconus patients.

Study design: Retrospective observational cohort study.

Methods: This retrospective study included 40 eyes of 40 pediatric keratoconus patients who underwent accelerated CXL (10 min/9 mW/cm²) and were followed at least 60 months after CXL. Corrected distance visual acuity, keratometry (K), anterior elevation, posterior elevation, asphericity, corneal densitometry, Belin/Ambrósio enhanced ectasia display and ABCD progression display values ​were recorded at baseline and 12 and 60 months after CXL.

Results: Iimprovements in visual acuity, gauged by regression in anterior curvature, progression in posterior curvature and corneal thickness, were observed using the ABCD progression display at the end of the 60 months follow-up. Significant improvements in K1, K2, maximum keratometry, anterior elevation and anterior asphericity values and significant worsening in the posterior elevation values were observed with topographical parameters. Significant thinning in pachymetric indices was observed with Belin/Ambrósio enhanced ectasia display.

Conclusion: Accelerated CXL is efficient in pediatric keratoconus patients in halting the disease progression. Visual and keratometric stabilization continued over a long follow-up period of 60 months. Belin ectasia progression display may be very helpful in the longitudinal follow-up of pediatric keratoconus patients after CXL.