Journal of Refractive Surgery · 2012 · 129 citations · 16 references
MedicineOphthalmologyPediatricsOphthalmic SurgeryPediatric OphthalmologyRefractive SurgeryCorneal DiseaseCorneal DisordersCorneal OpticsCorneal TopographyPediatric Corneal DisordersPediatric Eye DiseaseAcuity In Corneal DiseaseCollagen Cross-linking ChangesCollagen-based Corneal MaterialsKeratoconus SurgeryPediatric Corneal SurgeryUncorrected Visual AcuityVisual Acuity ImpairmentVisual Acuity Improvement
PURPOSE: To evaluate the safety and efficacy of corneal collagen cross-linking (CXL) in the treatment of keratoconus in pediatric patients. METHODS: Epithelium-off CXL using the standard protocol was performed in 15 eyes from 15 patients (age range: 10 to 15 years) with moderate keratoconus in 1 eye and advanced disease in the fellow eye. Principal outcomes included uncorrected and corrected distance visual acuity (CDVA), refraction, and topography-derived outcomes of maximum and average keratometry (K). RESULTS: Mean uncorrected distance visual acuity improved significantly from 1.00 ± 0.30 (20/200) to 0.72 ± 0.29 (20/100) logMAR (P=.035) and mean CDVA from 0.56 ± 0.21 (20/70) to 0.30 ± 0.15 (20/40) logMAR (P=.003) at the end of 12 months. Mean change in apical K (1.01 ± 2.40 diopters) was also significant (P=.004). No significant complications were noted. CONCLUSIONS: Corneal collagen CXL was found to be safe and effective in the first 12 months for keratoconus in children with similar initial efficacy as in adults in terms of improvement in visual and topographic outcomes.
16