Outcomes Following Crosslinking for Keratoconus in Pediatric Population
Euna B. Koo, MD; Scott R. Lambert, MD; Edward E. Manche, MD
Stanford University School of Medicine
Palo Alto, CA
Introduction: The aim of this study was to assess corneal changes in keratometry (K) and best corrected visual acuity (BCVA) following crosslinking in pediatric patients with keratoconus.
Methods: A retrospective chart review was performed on patients </=20 years of age who underwent corneal cross linking in the last 5 years. Delta BCVA (logmar) was defined as the difference between postoperative and preoperative BCVA. Delta Kmax was defined as the difference between postoperative and preoperative steepest K (diopters). If delta BCVA divided by time since surgery (years) was <+/-0.1 logmar/year, the vision was defined as stable.
Results: Sixteen patients met inclusion criteria for the chart review. Fifteen patients (18 eyes) had complete preoperative and postoperative data that could be analyzed for at least one eye. Range of follow up after surgery was 1 month to 3 years (median of 1 year). Of the 15 patients, 12 were males and 3 females. Age at first intervention ranged from 9 to 20 years (median of 17 years). Preoperative BCVA ranged from 20/20-1 to CF at 4 feet (median of 20/50-3). Postoperative BCVA ranged from 20/20+2 to 20/200 (median of 20/32-3). The difference between the post- and pre-operative K’s (post-op K-preop K= ^K) ranged from -2.5 to 0.9 diopters (median -0.45). Six patients had stabilized vision, 10 improved vision, and 2 had worsened vision.
Discussion: The results of this study indicate that crosslinking in the pediatric population stabilizes and in some cases even improves corneal keratometry and vision.
Conclusion: Crosslinking should be strongly considered in managing pediatric patients with keratoconus.
References: 1. Godefrooij DA, Soeters N, Imhof SM, Wisse RP. Corneal Cross-Linking for Pediatric Keratoconus: Long-Term Results. Cornea. 2016;35(7):954-958.
2. Chatzis N, Hafezi F. Progression of keratoconus and efficacy of pediatric [corrected] corneal collagen cross-linking in children and adolescents. J Refract Surg. 2012;28(11):753-758.
3. El-Khoury S, Abdelmassih Y, Hamade A, et al. Pediatric Keratoconus in a Tertiary Referral Center: Incidence, Presentation, Risk Factors, and Treatment. J Refract Surg. 2016;32(8):534-541.