keratoconus onset typically occurs in the teenage years and early 20s. Some concerns have been raised regarding what should be the youngest age limit for treatment. Crosslinking a young cornea is not expected to have any adverse side effects; older patients or diabetic patients with significant crosslinking in the corneal stroma do not have any adverse effects.
Perhaps the most practical concern is whether the C3-R® works and lasts in young patients with aggressively progressive keratoconus. The youngest patient treated in the published literature is 13 years old in the original study by Wollensak et al.The follow up of this patient was 47 months with no changes in endothelial cell count, lens and corneal transparency. Our youngest treated patient is also 13 years old. He had aggressively progressing keratoconus and following the treatment, complete stabilization was achieved. As corneal and refractive specialists, we have seen thousands of patients with varying degrees of keratoconus, including severe end-stage disease that require corneal transplant. A young patient with progressive keratoconus can in a short period of time dramatically progress and result in lost the ability to function in glasses or soft contact lenses due to visual distortions and required RGP contacts that were not comfortable. With further progression, this patient may require a cornea transplant to help improve vision function and after healed will still require corrective lenses.
