Purpose:

To investigate the results of corneal cross-linking (CXL) combining a hypotonic riboflavin solution containing hydroxypropyl methylcellulose (HPMC) followed by short UV irradiation time in children.

Methods:

A prospective case series of children (younger than 18 years old) with progressive keratoconus underwent accelerated CXL (10 min - 9mW/cm2) after soaking of hypotonic riboflavin using HPMC as the carrier. The parameters examined were changes in uncorrected visual acuity (UDVA), corrected visual acuity (CDVA), keratometry values (mean, flat, steep, and apical), pachymetry, and endothelial cell count at the baseline and at 6 and 12 months postoperatively.

Results:

Thirty-five eyes of 28 patients were enrolled in the study. The mean patient age was 13.2 years. One year after CXL treatment, the UDVA (P < 0.001),="" cdva="" (p="" />< 0.001),="" and="" spherical="" equivalent="" (p="0.027)" improved="" significantly.="" the="" corneal="" topographic="" data="" revealed="" significant="" decreases="" in="" steepest="" (mean="" value="" pre="" (60.14="" d)="" to="" post="" op="" (58.27d),="" p="" />< 0.001),="" and="" flattest="" keratometry="" (mean="" pre-op="" value="" (52.01="" d)="" to="" post-op="" (50.06d),="" p="" />< 0.001)="" compared="" with="" the="" baseline="" measurements.="" endothelial="" cell="" count="" was="" not="" significantly="" different="" at="" the="" end="" of="" the="" study.="" 0.001)="" compared="" with="" the="" baseline="" measurements.="" endothelial="" cell="" count="" was="" not="" significantly="" different="" at="" the="" end="" of="" the="" />

Conclusions:

CXL combining a hypotonic riboflavin soaking using HPMC as the carrier followed by a short UV irradiation (10 min) was safe and effective halting the keratoconus progression in children. A significant reduction was observed in keratometry measurements, which correlated with an improvement in visual acuity.