Efficacy of Corneal Cross-Linking in the Treatment of Pediatric Keratoconus: A Retrospective Interventional Study
نویسندگان
1 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
2 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
3 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
4 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
5 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
6 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
7 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
8 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
9 Department of Ophthalmology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
10 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
11 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
12 General Administration of Medical Affairs, Sohag University, Sohag, Egypt
13 Department of Ophthalmology, Faculty of Medicine for Girls, Al-Azhar University, Assiut, Egypt
14 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
15 Department of Ophthalmology, Faculty of Medicine for Girls, Al-Azhar University, Damietta, Egypt
16 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
doi
10.48309/jmcs.2026.557649.2898چکیده
Corneal collagen cross-linking (CXL) has emerged as a promising technique to strengthen corneal biomechanics and arrest ectatic progression, particularly with the standard epithelium-off (epi-off) protocol. This study aimed to evaluate the efficacy and safety of standard epithelium-off corneal collagen cross-linking (SCXL) in halting or reducing the progression of keratoconus in pediatric patients, with particular emphasis on changes in corneal curvature, visual acuity, corneal thickness, and postoperative complications. A retrospective observational study was conducted at the Ophthalmology Department, Damietta Faculty of Medicine, Al-Azhar University, including 40 eyes of 20 pediatric patients (aged 8–18 years) with progressive keratoconus who had previously undergone standard epi-off CXL. Clinical data were collected from medical records, including best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, corneal tomography, pachymetry, and keratometry at baseline and follow-up visits. The primary outcome was the change in maximum keratometry (Kmax) at 12 months, while secondary outcomes included BCVA, corneal thickness, and postoperative complications. At the 12-month follow-up, mean Kmax showed a statistically significant reduction from baseline (p < 0.05), indicating corneal flattening and stabilization of ectatic progression in more than 90% of treated eyes. BCVA demonstrated significant improvement, with an average gain of approximately 0.07 logMAR (p < 0.05). Postoperative corneal thinning was minimal, with no cases exceeding safety thresholds. Transient corneal haze was observed in a small number of eyes and resolved within 3–6 months under conservative treatment. No instances of infectious keratitis or persistent epithelial defects were reported. In conclusion, standard epithelium-off corneal collagen cross-linking is an effective and safe treatment for pediatric keratoconus. It halts disease progression, enhances visual acuity, and induces favorable topographic changes with minimal, self-limiting complications. Early diagnosis and timely intervention remain critical for visual preservation in this vulnerable population.
