{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:35:57Z","timestamp":1786649757481,"version":"build-2736575974"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To study the long-term clinical outcome of the bilateral simultaneous accelerated corneal collagen cross-linking (ACXL) procedure in progressive keratoconus in the pediatric population at 24-month follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This is a retrospective cross-sectional study that included 39 patients (78 eyes) with progressive pediatric keratoconus treated with epi-off bilateral ACXL in the same sitting between 2018 and 2022. The change in pre-operative vs. post-operative distance-corrected visual acuity (DCVA), average keratometry, maximum keratometry (Kmax), and thinnest corneal thickness (TCT) values was assessed at the end of 24 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 78 eyes of 39 patients with a mean age of 15.2 \u00b1 1.8 years were taken. About 27 (69.2%) were males, and 12 (30.7%) were females. At 24 months, there was a significant improvement in the mean DCVA of 0.256 \u00b1 0.319 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.00001) and 0.239 \u00b1 0.319 logMAR units (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.00001) for the right (RE) and left eye (LE), respectively. The average keratometry (Avg K) decreased significantly from 48.65 \u00b1 5.63 to 47.82 \u00b1 5.43 D (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.00069) and from 49.76 \u00b1 5.17 to 47.7 \u00b1 4.68 D for RE and LE, respectively. Pre-operative TCT in RE and LE was 445.15 \u00b1 48.49 \u00b5m and 444.46 \u00b1 45.81 \u00b5m which stabilized post-operatively in RE at 439.51 \u00b1 47.18 \u00b5m and in LE at 434.24 \u00b1 48.24 \u00b5m (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.00456). No significant side effects (permanent corneal haze, keratitis, or endothelial damage) were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Bilateral simultaneous ACXL is an effective and safe procedure to improve compliance due to a shorter operative time, especially in the pediatric population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_1967_24","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T11:00:34Z","timestamp":1745492434000},"page":"769-774","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Bilateral simultaneous accelerated corneal collagen cross-linking in pediatric keratoconus: 24-month follow-up results"],"prefix":"10.4103","volume":"73","author":[{"given":"Devansh","family":"Virdi","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalini","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Swanetra Eye Hospital, Jaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swati","family":"Tomar","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Swanetra Eye Hospital, Jaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tejinder Singh","family":"Ahluwalia","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, 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