nach oben

International Ophthalmology

Erschienen in:

01.12.2024 | Original Paper

Outcomes after corneal crosslinking treatment in paediatric patients with keratoconus

verfasst von: Cem Cankaya, Nur Gungor

Erschienen in: International Ophthalmology | Ausgabe 1/2024

Einloggen, um Zugang zu erhalten

Abstract

Purpose

This study aims to determine the efficacy and safety of accelerated corneal crosslinking in children with keratoconus.

Methods

The study enrolled 64 patients aged 16 years or younger, each contributing one eye for a total of 64 eyes for analysis. Participants underwent an accelerated form of corneal cross-linking with 15 min of ultraviolet A irradiation at a rate of 7 mW/cm², resulting in a cumulative energy dose of 5.4 J/cm². The primary outcome measures were best corrected visual acuity (BCVA) and corneal tomography at 6 and 12 months post-intervention. Parameters assessed included BCVA, spherical and cylindrical refraction, keratometry (K1 and K2), maximum keratometry (Kmax) and thinnest corneal thickness (TCT). These metrics were documented preoperatively and then again at 6 and 12 months postoperatively. In addition, any ocular or systemic conditions related to keratoconus were recorded for each participant.

Results

The results showed an improvement in BCVA at 12 months after surgery. K1 showed a decrease at both post-operative follow-ups while K2 remained constant throughout the observation period. Kmax showed a notable decrease at the 12 month postoperative follow-up. Although the TCT showed an initial decrease, it reached a stable state after 12 months of crosslinking. Refractive values remained stable at all subsequent examinations. Notably, no complications such as corneal opacity, non-healing epithelial defects or corneal infections occurred during the follow-up period. The most common ocular comorbidity was allergic conjunctivitis (34.4%).

Conclusion

The findings suggest that accelerated corneal crosslinking treatment is effective in slowing or halting the progression of keratoconus. Furthermore, there were no persistent overt complications observed at 12 months after the procedure.

Nur mit Berechtigung zugänglich

Rubido JS, Carracedo G, Suzaki A et al (2022) Keratoconus: an updated review. Cont Lens Anterior Eye 45(3):101559. https://doi.org/10.1016/j.clae.2021.101559. (Epub 2022 Jan 4)CrossRef

Buzzonetti L, Bohringer D, Liskova P et al (2020) Keratoconus in children: a literature review. Cornea 39:1592–1598. https://doi.org/10.1097/ICO.0000000000002420CrossRefPubMed

Agca A, Tulu B, Yasa D et al (2020) Accelerated corneal crosslinking in children with keratoconus: 5-year results and comparison of 2 protocols. J Cataract Refract Surg 46:517–523. https://doi.org/10.1097/j.jcrs.0000000000000101CrossRefPubMed

Chatzis N, Hafezi F (2012) Progression of keratoconus and efficacy of pediatric corneal collagen cross-linking in children and adolescents. J Refract Surg 28:753–758. https://doi.org/10.3928/1081597X-20121011-01CrossRefPubMed

Lim L, Lim EWL (2018) A review of corneal collagen cross-linking–current trends in practice applications. Open Ophthalmol J 12:181–213. https://doi.org/10.2174/1874364101812010181CrossRefPubMedPubMedCentral

Sorkin N, Varssano D (2014) Corneal collagen crosslinking: a systematic review. Ophthalmologica 232:10–27. https://doi.org/10.1159/000357979CrossRefPubMed

Reeves SW, Stinnett S, Adelman RA et al (2005) Risk factors for progression to penetrating keratoplasty in patients with keratoconus. Am J Ophthalmol 140:607–611. https://doi.org/10.1016/j.ajo.2005.05.029CrossRefPubMed

Kankariya VP, Kymionis GD, Diakonis VF et al (2013) Management of pediatric keratoconus–evolving role of corneal collagen cross-linking: an update. Indian J Ophthalmol 61:435–440. https://doi.org/10.4103/0301-4738.116070CrossRefPubMedPubMedCentral

Daxer A, Misof K, Grabner B et al (1998) Collagen fibrils in the human corneal stroma: structure and aging. Invest Ophthalmol Vis Sci 39:644–648PubMed

10.

Gomes JA, Tan D, Rapuano CJ et al (2015) Global consensus on keratoconus and ectatic diseases. Cornea 34:359–369. https://doi.org/10.1097/ICO.0000000000000408CrossRefPubMed

11.

Magli A, Forte R, Tortori A et al (2013) Epithelium-off corneal collagen cross-linking versus transepithelial cross-linking for pediatric keratoconus. Cornea 32:597–601. https://doi.org/10.1097/ICO.0b013e31826cf32dCrossRefPubMed

12.

Wise S, Diaz C, Termote K et al (2016) Corneal cross-linking in pediatric patients with progressive keratoconus. Cornea 35:1441–1443. https://doi.org/10.1097/ICO.0000000000000923CrossRefPubMed

13.

Shetty R, Nagaraja H, Jayadev C et al (2014) Accelerated corneal collagen cross-linking in pediatric patients: two-year follow-up results. Biomed Res Int. https://doi.org/10.1155/2014/894095CrossRefPubMedPubMedCentral

14.

Vinciguerra P, Albé E, Frueh BE et al (2012) Two-year corneal cross-linking results in patients younger than 18 years with documented progressive keratoconus. Am J Ophthalmol 154:520–526. https://doi.org/10.1016/j.ajo.2012.03.020. (Epub 2012 May 24)CrossRefPubMed

15.

Viswanathan D, Kumar NL, Males JJ (2014) Outcome of corneal collagen crosslinking for progressive keratoconus in paediatric patients. Biomed Res Int. https://doi.org/10.1155/2014/140461CrossRefPubMedPubMedCentral

16.

Peyman A, Kamali A, Khushabi M et al (2015) Collagen cross-linking effect on progressive keratoconus in patients younger than 18 years of age: a clinical trial. Adv Biomed Res 4:245. https://doi.org/10.4103/2277-9175.170240.eCollectionCrossRefPubMedPubMedCentral

17.

Ozgurhan EB, Kara N, Cankaya KI et al (2014) Accelerated corneal cross-linking in pediatric patients with keratoconus: 24-month outcomes. J Refract Surg 30:843–849. https://doi.org/10.3928/1081597X-20141120-01CrossRefPubMed

18.

Arora R, Gupta D, Goyal JL et al (2012) Results of corneal collagen cross-linking in pediatric patients. J Refract Surg 28:759–762. https://doi.org/10.3928/1081597X-20121011-02CrossRefPubMed

19.

Badawi AE (2017) Accelerated corneal collagen cross-linking in pediatric keratoconus: one year study. Saudi J Ophthalmol 31:11–18. https://doi.org/10.1016/j.sjopt.2017.01.002. (Epub 2017 Jan 25)CrossRefPubMedPubMedCentral

20.

Caporossi A, Mazzotta C, Baiocchi S et al (2012) Riboflavin-UVA-induced corneal collagen cross-linking in pediatric patients. Cornea 31:227–231. https://doi.org/10.1097/ico.0b013e31822159f6CrossRefPubMed

21.

Uçakhan OO, Bayraktutar BN, Saglik A (2016) Pediatric corneal collagen cross-linking: long-term follow-up of visual, refractive, and topographic outcomes. Cornea 35:162–168. https://doi.org/10.1097/ICO.0000000000000702CrossRefPubMed

22.

Greenstein SA, Shah VP, Fry KL et al (2011) Corneal thickness changes after corneal collagen crosslinking for keratoconus and corneal ectasia: one-year results. J Cataract Refract Surg 37:691–700. https://doi.org/10.1016/j.jcrs.2010.10.052CrossRefPubMed

23.

Ghosh A, Zhou L, Ghosh A et al (2013) Proteomic and gene expression patterns of keratoconus. Indian J Ophthalmol 61:389–391. https://doi.org/10.4103/0301-4738.116056CrossRefPubMedPubMedCentral

24.

Rahi A, Davies P, Ruben M et al (1977) Keratoconus and coexisting atopic disease. Br J Ophthalmol 61:761–764. https://doi.org/10.1136/bjo.61.12.761CrossRefPubMedPubMedCentral

Titel: Outcomes after corneal crosslinking treatment in paediatric patients with keratoconus
verfasst von: Cem Cankaya
Nur Gungor
Publikationsdatum: 01.12.2024
Verlag: Springer Netherlands
Erschienen in: International Ophthalmology / Ausgabe 1/2024
Print ISSN: 0165-5701
Elektronische ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-024-02996-z

Update Augenheilkunde

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Outcomes after corneal crosslinking treatment in paediatric patients with keratoconus

Abstract

Purpose

Methods

Results

Conclusion

Neu im Fachgebiet Augenheilkunde

Ophthalmika in der Schwangerschaft

Operative Therapie und Keimnachweis bei endogener Endophthalmitis

Bakterielle endogene Endophthalmitis

So erreichen Sie eine bestmögliche Wundheilung der Kornea

Update Augenheilkunde

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2024

Thickness of anterior sclera and corneal layers in systemic sclerosis

Impact of removing soft contact lenses 1 day versus 1 month before surgery on the outcomes of microkeratome laser in situ keratomileusis

The comparison of corneal densitometry in cases with glaucoma following childhood cataract surgery and juvenile glaucoma

Corneal endothelial cell loss and intraocular pressure following phacoemulsification using a new viscous-cohesive ophthalmic viscosurgical device

Impact of demographic factors on corneal donor recovery

Accuracy of intraocular lens formulas in combined phacovitrectomy

Neu im Fachgebiet Augenheilkunde

Ophthalmika in der Schwangerschaft

Operative Therapie und Keimnachweis bei endogener Endophthalmitis

Bakterielle endogene Endophthalmitis

So erreichen Sie eine bestmögliche Wundheilung der Kornea

Update Augenheilkunde