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Evaluate the safety and efficacy of epi-off corneal cross-linking (CXL) in adolescents with progressive keratoconus (KC). Private clinical practice DESIGN Nonrandomized prospective clinical trial METHODS 230 adolescent patients aged 10-19 years old with progressive keratoconus (increasing maximum keratometry (Kmax) or astigmatism of ≥ 1 D associated with decreased corrected distance visual acuity (CDVA)) underwent CXL. Exclusion criteria were age at time of CXL 10 years or 19 years, corneas that were thinner than 400 μm or dem