comparing two faster corneal cross linking treatments using vitamin e tpgs in children with keratoconus

INTERVENTION: Intervention1: Group 1 Vitamin E TPGS riboflavin group 9mW per cm2 for 10min: ribofast dye containing 0.1 percent ribolflavin enhanced with vit e tpgs will be instilled for 20 minutes. 1 drop every 2 min total of 10 drops followed by irradiation with uv a light for 10 minutes with power of 9 mw per cm2 Intervention2: Group 2 Vitamin E TPGS riboflavin group 6mW per cm2 for 15 min: ribofast dye containing 0.1 percent ribolflavin enhanced with vitamin e tpgs will be instilled for 20 minutes, 1 drop every 2 min total of 10 drops followed by irradiation with uv a light for 15 minutes with power of 6 mw per cm2 Control Intervention1: corneal cross linking HPMC riboflavin group 9mW per cm2 for 10min: peschke m dye containing 0.1 percent ribolflavin with 1.1 percent hpmc will be instilled for 20 minutes. 1 drop every 2 min total of 10 drops followed by irradiation with uv a light for 10 minutes with power of 9 mw per cm2 CONDITION: Health Condition 1: H186‐ Keratoconus PRIMARY OUTCOME: Demarcation line depth and visibility on Swept source OCTTimepoint: Baseline and at 12 weeks after the intervention SECONDARY OUTCOME: 1 Change in total corneal densitometry at 3 months post CXL compared to pre CXL values ; 2 Change in maximum keratometry at 6 months after CXL compared to pre CXL valuesTimepoint: 3 months and 6 months INCLUSION CRITERIA: 1 Age less than equal to 18 years 2 Thinnest pachymetry of more than or equal to 375 micrometre on Pentacam 3 Kma Xof less than or equal to 68D on Scheimpflug imaging with Pentacam 4 Grade 1 to 3 keratoconus by Belin ABCD classification on Pentacam 5 Corrected distance visual acuity of less than 20/20 on the Snellen vision chart 6 Endothelial cell density of more than 2000 cells per mm3 7 Absence of any ocular surface disorders