Review Article

An Update on the Safety and Efficacy of Corneal Collagen Cross-Linking in Pediatric Keratoconus

Table 1

Variability of the criteria used to define keratoconus progression in different studies.

StudyVisual acuityRefractionKeratometryPachymetryTopographyConsiderations

Caporossi et al. [30]UCVA/BSCVA decrease ≥ 1 Snellen lineΔSph or ΔCyl > 0.5 D > 0.5 DDecrease in thinnest pachymetry ≥ 10 μmΔSAI/SI > 0.5 DAt least 2 parameters in 3 months

Caporossi et al. [31]UCVA/BSCVA decrease ≥ 1 Snellen lineΔSph or ΔCyl > 0.5 D > 1 DDecrease in thinnest pachymetry ≥ 10 μmΔSAI/SI > 0.5 DAt least 3 parameters (1 clinical and 2 instrumental) in 3 months

Vinciguerra et al. [32]Change in Sph or Cyl ≥ 3 D ≥ 1.5 D on 2 consecutive topographiesDecrease in CCT ≥ 5% on 3 consecutive tomographiesAny parameter in 3 months

Zotta et al. [33]ΔSE > 0.75 D of cone apex > 0.75 DAny parameter in 6 months

Chatzis and Hafezi [34] > 1 DFollow-up period of maximum 12 months

Bakshi et al. [35]ΔCyl ≥ 1.5 D ≥ 1.5 DAny parameter at 3 time points in 12 months

Magli et al. [36]ΔCyl > 1 D of cone apex > 1 DAny parameter in 6 months

Shetty et al. [32, 37] > 1–1.5 D with corresponding change in refractionDecrease in thinnest pachymetry ≥ 5%Any parameter in 6 months

Zotta et al. [33]ΔCyl ≥ 1 D and ΔSE ≥ 0.5 D ≥ 1 DAll 3 parameters on consecutive examinations

UCVA: uncorrected visual acuity, BSCVA: best spectacle corrected visual acuity, Sph: sphere, Cyl: cylinder, SAI: surface asymmetry index, SI: symmetry index, CCT: central corneal thickness, SE: spherical equivalent, and Δ: increase in.