An Italian study, recently published in Cornea, compared the effectiveness of epi-on versus epi off crosslinking in pediatric patients. The authors found that standard epi-off CXL halted keratoconus progression in 75% of eyes during the 3 years after treatment. By contrast, I-ON CXL seemed to slow down keratoconus progression in 50% of eyes, mainly in those with highest Kmax and paracentral cone.