Eficácia do crosslinking corneano em portadores de ceratocone com idade inferior a 18 anos

Abstract

Keratoconus presents certain specificities in pediatric patients compared with adults. The greatest challenge is because the disease is typically more severe and progresses faster in children. This retrospective study aimed to report crosslinking procedure in patients under 18 years of age and their follow-up for at least 24 months after the procedure. Methods: Overall, 12 eyes from 10 patients were studied and data, such as visual acuity with and without correction, maximum keratometry, corneal thickness, foveal thickness, and endothelial microscopy, were assessed at both preoperative and postoperative visits. Corneal crosslinking was performed in all patients. Results: A tendency toward reduced K max and improved Corrected Distance Visual Acuity at all postoperative moments. Only one of the 12 eyes exhibited increased K max of more than 1 D during a time frame longer than 12 months. Regarding pachymetry, a tendency for corneal thinning was observed in the first four months after surgery. Conclusion: Encouraging results were obtained regarding the stabilization of the disease, progression, and procedural safety, corroborating to other authors' findings. The significance of early diagnosis and short-term follow-up were highlighted.

Changes in corneal biomechanical parameters in keratoconus eyes with various severities after corneal cross-linking (CXL): A comparative study

“…14,15 Similar stability in the refractive status expressed by MSE was seen the same as the study by Tasci and colleagues in 5 years follow up after CXL. 16 Although significant changes in MSE or corrected distance visual acuity of the eye were reported in some studies 7 ; however, the absence of such a change does not indicate the ineffectiveness of CXL, as this technique is a corneal stabilizing method and not a refractive surgery technique method that aims to cause considerable changes in refraction. It was reported that CXL's effect on the refractive power is not via changes in the corneal curvature, but other factors such as changes in index of refraction and/or corneal hydration.…”

“…CXL is increasingly used in the treatment of keratoconus and can reduce its progression, the associated considerable impairment of vision-related quality of life, and ultimately the financial burden and socio-economic problems of this disorder. 5,6 Biomechanical and microstructural changes in corneal stroma through the photo-polymerization reaction in the CXL technique improve the mechanical strength of the cornea or corneal stiffness of the anterior corneal stroma, 7,8 which has been confirmed in ex vivo and experimental studies, although these measurements differ from in vivo assessments due to the destruction of the natural state of the cornea. 9 There are several grading systems for KCN severity classification, one of which is the system designed based on the collaborative longitudinal evaluation of keratoconus (CLEK) study, which divided the KCN into mild, moderate, and severe grades.…”