Researchers did this study to investigate the long-term safety and efficacy of accelerated transepithelial corneal cross-linking (ATE-CXL) in children with progressive keratoconus.

Fifty-three eyes of 41 paediatric patients undergoing ATE-CXL were enrolled in the study. Researchers assessed corrected distance visual acuity and manifest refraction preoperatively and 36 months postoperatively. Corneal keratometry, corneal thickness, and posterior elevation were measured using Pentacam preoperatively and 1, 6, 12, and 36 months postoperatively. Pachymetry and epithelial thicknesses were measured using optical coherence tomography preoperatively and 6, 12, and 36 months postoperatively.

Thirty-six months postoperatively, CDVA improved from 0.32±0.28 to 0.26±0.25 in the logarithm of the minimum angle resolution. Similarly, central corneal thickness, which was 492.42±33.83 µm postoperatively, also remained stable during the 36-month follow-up. Both prominent posterior elevation and posterior highest elevation were steady at 12 months after ATE-CXL but increased at 36 months post-procedure. Corneal pachymetry and epithelial thicknesses remained stable throughout the follow-up period.

The study concluded ATE-CXL is a safe and effective treatment in paediatric progressive keratoconus patients, leading to stable keratometry and corneal thickness throughout the 36-month follow-up.