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Middle East Afr J Ophthalmol. 2016 Jan-Mar;23(1):129-34. doi: 10.4103/0974-9233.171775.

Corneal Biomechanical and Anterior Chamber Parameters Variations after 1-year of Transepithelial Corneal Collagen Cross-linking in Eyes of Children with Keratoconus.

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Department of Ophthalmology, Ain Shams University, Cairo, Egypt.



To assess the changes in corneal hysteresis (CH) and corneal resistance factor (CRF) 1-year following transepithelial corneal collagen cross-linking (CXL) treatment in eyes of children with keratoconus.


This case series was conducted in 22 eyes of 22 children. Children aged < 18 years with progressive keratoconus were included. They were treated with transepithelial CXL. Corneal biomechanical and anterior chamber parameters such as CH, CRF, and peak 1 were noted using ocular response analyzer, Pentacam, intraocular lens master, and anterior segment optical coherence tomography before and 1, 3, 6, and 12 months after treatment.


Our series had 22 eyes of 22 children with a mean age 15.7 ± 2.1 years. The CH and CRF 1-year after treatment declined (difference of mean 0.1 mmHg (95% confidence interval [CI] 0.04-0.24), P = 0.2] and (difference of mean 0.1 mmHg [95% CI 0.04-0.30], P = 0.3), respectively. Peak 1 and peak 2 increased (difference of mean 0.1 mmHg [95% CI 0.006-0.008], P = 0.2) and (difference of mean 0.1 mmHg [95% CI 0.007-0.006], P = 0.3), respectively. The uncorrected distance visual acuity improved from 0.95 ± 0.34 logMAR to 0.68 ± 0.45 logMAR (P < 0.05). No statistically significant changes during 12 months follow-up were observed in axial length, corneal volume, anterior chamber volume, and anterior chamber depth (P > 0.05).


Transepithelial CXL in keratoconus in pediatric age group seems to have good stability in corneal biomechanical parameters after 1-year. Further studies with a larger sample and better study design are recommended to confirm our findings.


Corneal Hysteresis; Corneal Resistance Factor; Pediatric Keratoconus; Transepithelial Corneal Cross Linking

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