This Issue At A Glance

Vinciguerra et al (p. 908) evaluated the 4-year outcomes of corneal cross-linking (CXL) for progressive keratoconus, focusing on results according to age. They found that CXL was effective in stabilizing ectatic disease progression in all age groups, while better functional and morphological results occurred in patients between ages 18 and 39. The study involved 400 eyes of 301 patients stratified into 4 different age groups: under 18, 18–9, 30–39, and over 40 years. All age groups experienced a significant improvement in best corrected visual acuity (BCVA). Additionally, patients demonstrated a significant decrease in spherical equivalent and a decrease in topographic parameters, including simulated keratometry 1 (Simk1), Simk2, surface asymmetry index (SAI), opposite sector index (OSI), and differential sector index (DSI), confirming previous data showing that CXL can regularize corneal shape. The investigators' main finding suggested that patients between 18 and 39 are the best responders to CXL. This report may help ophthalmic surgeons select appropriate patients and predict outcomes of CXL to treat keratoconus.