Keratoconus pp 249-252 | Cite as

Pediatric Corneal Cross-Linking

  • Sabine Kling
  • Farhad Hafezi
Part of the Essentials in Ophthalmology book series (ESSENTIALS)


Corneal cross-linking (CXL) is a treatment for keratoconus that preserves the corneal tissue in contrast to keratoplasty. CXL has been successfully applied clinically in adult patients for more than a decade. While keratoconus in pediatric patients is often detected at a late stage and progresses fast, clinical management is more difficult. Children have also been reported to benefit from CXL; however, the durability of the treatment effect remains unclear. An important subgroup of pediatric patients are people with trisomy 21, which have an elevated incidence rate of keratoconus (1:64) compared to the general population (1:1250). Due to reduced patient compliance and hence increased risk of postsurgical complications, the Geneva protocol has been developed, which gives recommendations on the kind of anesthesia (topical or general) and the CXL protocol (epi-on or epi-off) for challenging patients.


Pediatric Corneal cross-linking Clinical Keratoconus Transepithelial Accelerated Trisomy 21 


Compliance with Ethical Requirements

Farhad Hafezi is co-founder of the Light for Sight Foundation. Sabine Kling has no conflict of interest. No human or animal studies were carried out by the authors for this article.


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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Center for Applied Biotechnology and Molecular Medicine (CABMM), University of ZurichZurichSwitzerland
  2. 2.ELZA InstituteDietikonSwitzerland
  3. 3.University of Southern CaliforniaLos AngelesUSA
  4. 4.University of GenevaGenevaSwitzerland

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