Performing corneal crosslinking under local anaesthesia in patients with Down syndrome

Purpose To report on the ability to perform corneal crosslinking (CXL) under local anaesthesia for the treatment of keratoconus in patients with Down syndrome. Methods Nine eyes of seven patients with both keratoconus and Down syndrome were scheduled for an epithelium-off CXL procedure under local anaesthesia. Exclusion criteria were a corneal thickness under 400 µm and the presence of corneal scars. A standardized clinical decision tool was used to estimate patient cooperation and the likelihood for a successful procedure under local rather than general anaesthesia. Results In seven eyes, the CXL was completed successfully. The treatment was aborted in two eyes due to insufficient corneal thickness (