Efficacy and Safety of 7.2 J/cm² Accelerated Corneal Cross-Linking in Pediatric and Adult Keratoconus: A Comparative Study.

To evaluate and compare the short-term outcomes of an accelerated corneal crosslinking (CXL) protocol with a total energy dose of 7.2 J/cm² in pediatric and adult keratoconus patients. This study included 113 eyes of 82 keratoconus patients who underwent accelerated epithelium-off CXL (12 mW/cm² for 10 minutes) at a university hospital. Patients were divided into two groups based on age: ≤18 years (Group 1, n=48 eyes) and >18 years (Group 2, n=65 eyes). Preoperative and postoperative (6-month) uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), keratometric indices (K1, K2, Kmax, Km), central corneal thickness (CCT), and endothelial cell density (ECD) were analyzed and compared between groups. Significant improvements in BCVA and reductions in keratometric indices were observed in both groups (p < 0.05). While both groups demonstrated significant visual and structural improvements, the adult group exhibited a greater magnitude of change in most keratometric and refractive parametersGroup 1 (mean age 15.4 ± 1.6 years) and Group 2 (mean age 23.4 ± 3.4 years) exhibited significant decreases in CCT (p < 0.001). Posterior keratometric values showed statistically significant changes in both groups (p < 0.001). ECD remained stable, and no severe complications were noted. Accelerated CXL with a total energy dose of 7.2 J/cm² demonstrated a favorable safety profile and significant efficacy in stabilizing keratoconus in both pediatric and adult patients over a 6-month period. Notably, adult patients exhibited a greater extent of keratometric and refractive improvement, suggesting a potentially age-dependent biomechanical response. These findings support the utility of this protocol as an early intervention strategy, particularly in young adults with progressive disease.