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Purpose: To assess the short term visual, refractive, and tomographic outcomes of corneal collagen cross-linking (CXL) in pediatric patients with keratoconus. Patients and Methods: A prospective interventional non-comparative case series study that was conducted in The Future Center for refractive surgery, Sohag, in the period from May 2017 to October 2018, All the eyes were treated with accelerated trans-epithelial corneal cross-linking under topical or general anesthesia and the following data were collected at baseline,3 months, 6 months, and 12 months postoperatively for all patients: uncorrectedand best-corrected visual acuity, sphere, spherical equivalent, cylinder, and tomographic findings. Results: A total of 50 eyes of 25 patients, 16 males (64%) and 9 females (36%) were included. Mean age at surgery was 15.76±1.67 years (range, 13-18). Mean uncorrected visual acuity was 0.83±0.30 logMAR at baseline and 0.74±0.33 logMAR at 12 months (P=0.009). Mean preoperative best-corrected visual acuity was 0.52±0.28 logMAR, which improved to 0.31±0.27 logMAR at 12 months (P<0.0001).Mean sphere was -3.17±3.95 at baseline and improved to -2.75± 3.55 at 12 months (P=0.01). Mean cylinder was -3.12±2.25 preoperatively and improved to -2.71± 2.56 at 12 months (P=0.052). Baseline spherical equivalent was-4.69±4.48 which improved to -4.08± 4.30 at 12 months (P=0.003). Mean baseline Kmax, Kmin, and Kmean values were 48.31±3.92, 44.48±2.73, 46.07±2.87 respectively; these values were stable at 12 months (P>0.05). There was non-significant reduction in the mean thinnest corneal area from baseline (453.36±40.50 mm) to 12 months (447.84±46.51 mm), (P=0.06). There were no significant postoperative complications. One case show progression at the 12 th month as the followings were noticed; The cylinder increased from -7.00 to -10.50, The flattest K increased from 55 D to 59 D, The steepest K increased from 58 D to 61 D, the corneal thickness at thinnest location decreased from 400 μm to 381 μm. Conclusion: In this study CXL effectively stabilized keratometry values at 12 month, while improving uncorrected visual acuity, best corrected visual acuity, and refractive indices.

OUTCOMES OF CORNEAL COLLAGEN CROSS LINKING IN PEDIATRIC KERATOCONUS IN UPPER EGYPT