AIM: To evaluate the efficacy and safety of iontophoresis-assisted transepithelial corneal cross-linking(I-CXL)in a population of patients younger than 18y.

METHODS: Fifteen eyes of 12 patients aged 18y or younger(mean age, 15.8±2.08y; range, 12-18y)were treated. After 0.1% riboflavin-distilled water solution was administered by iontophoresis-assisted(Current 1mA)transepithelial method for 5min in total, standard surface UVA irradiation(370 nm, 3 mW/cm² )was performed for 30min. The uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), K₁, K₂, K_max, K_mean, corneal refractive astigmatism, endothelial cell density, intraocular pressure(IOP), the corneal apex thickness and the thinnest corneal thickness were measured preoperatively 3mo and 12mo postoperatively. Corneal parameters were assessed by corneal topography(Wavelight, Allergro Topolyzer & Topolyzer Vario, Germany). Corneal endothelium was photographed with a noncontact Specular Microscope(SP 2000, Topcon, Japan).

RESULTS: Twelve months after the procedure, no significant changes occurred in the UCVA, BCVA, K₁, K₂, K_max, K_mean, corneal refractive astigmatism, endothelial cell density and IOP. The thinnest corneal thickness decreased from 468.08±33.40 μm to 447.46±40.20 μm(t=4.379, P=0.001). The corneal apex thickness decreased from 476.07±35.96 μm to 454.60±49.32 μm(t=4.270, P=0.001). The differences of the above were both statistically significant.

CONCLUSION:I-CXL using 0.1% riboflavin-distilled water solution for pediatric keratoconus is effective and safe which can halt deterioration of keratoconus within 1y, but permanent effects still need to be observed.