CXL yields good long-term results in patients younger than 18

This prospective study found that corneal cross-linking (CXL) improved UCVA and BSCVA in patients younger than 18 years of age, most likely by significantly reducing corneal asymmetry and corneal and total wavefront aberrations.

Subjects were 40 consecutive white patients with progressive, stage II keratoconus ranging in age from 9 to 18. They were followed for two years after a riboflavin-ultraviolet A-induced CXL procedure that included an abraded corneal endothelium and Ricrolin application.

After an initial worsening, all indices documented the progressive flattening of the ectatic cornea, which was accompanied by a significant improvement in UCVA and BSCVA. Endothelial cell counts did not change significantly.

The authors note that these patients exhibited a faster and more dramatic progression than adults. This underscores the importance of early diagnosis in children and of a tight follow-up schedule to identify those eyes that deteriorate rapidly.

They conclude that additional study is required to determine if CXL is as effective in children as it is in adults. The higher viscosity and lower resistance of younger corneas may make a difference in the end result.