A study conducted in Shanghai has established that accelerated transepithelial corneal crosslinking (ATE-CXL)—which maintains the integrity of the corneal epithelium with a higher but reduced duration of irradiation intensity of UV light—can be safe and effective for up to 36 months for pediatric patients with progressive keratoconus.

The researchers examined 53 eyes of 41 pediatric patients with progressive patients who received ATE-CXL. They assessed corrected distance visual acuity (CDVA) and manifest refraction preoperatively and 36 months postoperatively, and measured corneal keratometry, corneal thickness and posterior elevation preoperatively and one, six, 12 and 36 months postoperatively. Pachymetry and epithelial thicknesses were measured preoperatively and six, 12, and 36 months postoperatively.

After 36 months, CDVA improved from 0.32±0.28logMAR to 0.26±0.25logMAR. Maximum keratometry was 58.73±9.70D preoperatively and then 59.20±10.24D (one month post-op), 58.28±9.33D (six months), 57.88±9.99D (12 months) and 58.98±10.79D (36 months). While posterior central elevation and highest elevation were stable at 12 months after ATE-CXL, they increased at 36 months post-op. CDVA improved, while corneal pachymetry, central thickness and epithelial thicknesses remained stable throughout the three-year follow-up period.

Tian M, Jian W, Zhang X, et al. Three-year follow-up of accelerated transepithelial corneal cross-linking for progressive pediatric keratoconus. Br J Ophthalmol. February 12, 2020. [Epub ahead of print].