Purpose: The purpose of this study was to evaluate and compare the 5-year efficacy and safety of accelerated transepithelial (A-epi-on) corneal collagen cross-linking (CXL) with standard CXL (epi-off) in children with progressive keratoconus (KC). Methods: This prospective cohort study included 78 eyes of patients aged 18 years old or younger with progressive KC who underwent CXL at the Oftalmosalud Institute of Eyes, Lima, Peru. A-epi-on CXL was performed in 32 eyes (30′ of impregnation/5′ of irradiation at 18 mW/cm2) and epi-off CXL was performed in 46 eyes (30′of impregnation/30′ minutes of irradiation at 3 mW/cm2). Visual acuity, refraction, and the Scheimpflug imaging parameters were evaluated preoperatively and postoperatively at 1 and 5 years. Results: The best corrected visual acuity improved to 0.06 logarithm of the minimum angle of resolution (SD: 0.19, P = 0.03) and 0.09 logarithm of the minimum angle of resolution (SD: 0.13, P < 0.001) in the A-epi-on and epi-off groups, respectively. The mean flattening in the mean keratometry was 0.09 diopters (D) (SD: 0.68, P = 0.33) and 3.18 D (SD: 5.17, P < 0.001) in the A-epi-on CXL and Epi-off groups at the 5-year follow-up. Significant differences were found in the change at 1 and 5 years between the groups for cylinder reduction, flat and mean K, and pachymetry (all P < 0.05). The KC progression rate was 9.37% (3/32) in the A-epi-on CXL; no progression was found in the epi-off CXL group at the 5-year follow-up. Conclusions: Both procedures halted the progression of KC at the 5-year follow-up; however, epi-off CXL was safer and more effective when compared with A-epi-on CXL.

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Purpose: To evaluate the effectiveness and agreement of 3 optical biometers in measuring axial length (AL) and biometric parameters in the eyes of patients with mature cataracts. Setting: Oftalmosalud Instituto de Ojos, Peru. Design: Prospective, comparative study. Methods: Eyes with mature cataracts were examined. Three consecutive scans were performed with each device: the IOLMaster 700, the Galilei G6, and the Pentacam AXL. The following parameters were recorded: AL, anterior flat keratometry (K1), steep K (K2), anterior astigmatism, mean K (Km), anterior chamber depth (ACD), central corneal thickness (CCT), and lens thickness. Agreement between devices was assessed using the coefficient of correlation of concordance (CCC). Results: Forty-five eyes were included. After 3 attempts, the acquisition success rates in measuring mature cataracts were 84.4% (38/45), 42.2% (19/45), and 37.7% (17/45) for the IOLMaster, the Galilei, and the Pentacam, respectively. Significant differences were found between the Pentacam and the IOLMaster in terms of AL, K2, and CCT. Significant differences were found in terms of K1, K2, Km, ACD, and CCT between the Pentacam and the Galilei; and significant differences were found in AL, K1, Km, and ACD between the Galilei and the IOLMaster (P < .05 all). Good correlations were found between devices (>0.90) in terms of keratometries and AL. Conclusions: The IOLMaster 700 had the highest AL acquisition success rate when compared with the Pentacam AXL and Galilei G6. Good agreement between devices was found in terms of AL and K readings.

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