Factors Affecting Visual Gain after Accelerated Crosslinking in Pediatric Keratoconic Cases

INTRODUCTION: This study was designed to evaluate factors affecting visual gain following accelerated crosslinking (A-CXL) in pediatric cases with keratoconus.
METHODS: Pediatric patients with a diagnosis of keratoconus who underwent A-CXL for 10 minutes ultraviolet A (UV-A) 9 mW/cm² between February 2015 and May 2019 and had at least 1 year of follow-up data were analyzed retrospectively. Uncorrected visual acuity, best corrected visual acuity (BCVA), and refractive value changes (spherical, cylindrical values) at the preoperative and postoperative 12th month were compared. Correlation analysis was used to evaluate the relationships between visual gain and corneal topography values (K1, K2, Kmaximum [Kmax], anterior elevation, posterior elevation) obtained using a Sirius topography device (Costruzione Strumenti Oftalmici, Florence, Italy).
RESULTS: A total of 33 eyes of 22 patients (mean age: 16.85±1.15 years) who underwent A-CXL (9 mW/cm2 UVA irradiation for 10 minutes) were included in the study. The mean BCVA had increased from 0.45±0.27 logMAR to a mean of 0.33±0.24 logMAR at the end of 1 year (p=0.014). Changes to spherical and cylindrical values were not statistically significant (p>0.05). The correlation analysis revealed a statistically significant relationship between visual gain and the preoperative BCVA and the preoperative Kmax.
DISCUSSION AND CONCLUSION: The study results indicated that the visual gain at 1 year after A-CXL (10 minutes at 9 mW/cm²) was associated with preoperative BCVA and Kmax values in pediatric cases of keratoconus.