ArticleInternational ophthalmology2026
Pulsed accelerated corneal cross-linking for pediatric keratoconus: a prospective study from the Indian subcontinent.
Article in International ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo evaluate the 12 month visual, refractive, and tomographic outcomes of pulsed accelerated corneal collagen cross-linking (PACXL) in children with progressive keratoconus and to determine its safety and efficacy in an Indian pediatric cohort.
methodsThis was a prospective interventional study including 40 eyes of 31 children (< 18 years) with progressive keratoconus and a minimum corneal thickness ≥ 400 µm. All eyes underwent epithelium-off PACXL (9 mW/cm
resultsThe mean age was 15.4 ± 1.5 years (64.5% male). At 12 months, mean BSCVA improved from 0.31 ± 0.21 to 0.23 ± 0.22 logMAR (p = 0.005) and UCVA from 0.79 ± 0.46 to 0.71 ± 0.47 logMAR (p < 0.001). Mean Kmax decreased from 57.38 ± 6.22 to 56.8 ± 5.6 D. Median refractive cylinder reduced from - 2.0 to - 1.12 D (p = 0.036). Mean thinnest pachymetry declined from 446.15 ± 25.5 to 398.7 ± 43.7 µm (p < 0.001), indicating stromal compaction or possible stromal volume loss. Endothelial cell density remained stable (2843.9 ± 247 → 2828.3 ± 234 cells/mm
conclusionsPulsed accelerated CXL provided significant visual improvement and 85% topographic stabilization at 12 months in pediatric keratoconus, with no endothelial toxicity. It offers a time-efficient and safe early-intervention option for children in whom standard protocols are less feasible.
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