Corneal Cross-Linking for Pediatric Keratoconus
| Autor: | Nienke Soeters, Robert P L Wisse, Daniel A. Godefrooij, Saskia M. Imhof |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
corneal Keratoconus medicine.medical_specialty Adolescent genetic structures Ultraviolet Rays Corneal Stroma Riboflavin keratoconus Logistic regression law.invention Cohort Studies 03 medical and health sciences 0302 clinical medicine law Statistical significance Ophthalmology Journal Article medicine Humans Prospective Studies Child Prospective cohort study Dioptre Photosensitizing Agents Keratometer business.industry Long term results medicine.disease eye diseases Cross-Linking Reagents pediatric Photochemotherapy 030221 ophthalmology & optometry Female Collagen sense organs business 030217 neurology & neurosurgery Follow-Up Studies cross-linking Cohort study |
| Zdroj: | Cornea, 35(7), 954. Lippincott Williams and Wilkins |
| ISSN: | 0277-3740 |
| DOI: | 10.1097/ico.0000000000000819 |
| Popis: | PURPOSE: To assess the efficacy and safety of cross-linking in pediatric patients with keratoconus and to provide a systematic literature overview regarding this subject. METHODS: In this prospective cohort, 54 eyes of 36 pediatric patients with keratoconus underwent standard epithelium-off cross-linking. Follow-up measurements taken up to 5 years after treatment were compared with baseline values. Logistic regression was used to identify the underlying cause in case of progression despite treatment. Finally, a systematic search was performed in PubMed and Embase, and data were extracted and summarized. RESULTS: At all follow-up visits up to 5 years, maximum keratometry values improved significantly (mean change at 5 years -2.06 diopters (D), P = 0.01); moreover, average keratometry, uncorrected distance visual acuity, and corrected distance visual acuity improved at all follow-up times, though not always to the level of statistical significance. In 12 eyes (22%), keratoconus had progressed by ≥1.0 D by the last follow-up visit, despite corneal cross-linking. Cones that were more decentralized were identified as the underlying cause of disease progression. The systematic search yielded 17 unique articles: 10 articles on epithelium-off cross-linking, 2 on accelerated cross-linking, 2 on transepithelial cross-linking, 1 on both epithelium-off and transepithelial cross-linking, and 2 on transepithelial cross-linking with iontophoresis. CONCLUSIONS: Our long-term follow-up reveals that epithelium-off cross-linking is both apparently safe and effective when used to prevent keratoconus progression in pediatric patients. However, disease progression occurred in 22% of the treated eyes; this progression was attributed to a more decentralized cone location. |
| Databáze: | OpenAIRE |
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