Corneal Cross-Linking in Pediatric Patients: Evaluating Treated and Untreated Eyes—5-Year Follow-Up Results

Or, Lior; Rozenberg, Assaf; Abulafia, Adi; Avni, Isaac; Zadok, David

doi:10.1097/ico.0000000000001629

Cited by 30 publications

(33 citation statements)

References 22 publications

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“…Our results showed that the eyes remained stable with respect to Kmax 1 year after ATE-CXL when compared to the preoperative assessment, which may indicate that ATE-CXL is an effective treatment for halting the progression of pediatric keratoconus. Or et al ( 7 ) and Eissa et al ( 20 ) reported that Kmax remained stable 1 year after C-CXL and accelerated CXL (A-CXL) for pediatric patients with keratoconus, which was consistent with the results of our study.…”

Section: Discussionsupporting

confidence: 92%

“…The obtained results suggested no significant changes in CCT, TCT, and AT 1 year after ATE-CXL, which indicated the efficacy of stabilizing the corneal thickness in pediatric progressive keratoconus. Previous studies ( 6 , 7 , 21 ) assessing the C-CXL outcomes in pediatric patients with keratoconus reported a significant decrease in corneal thickness compared with preoperative results. In our study, the corneal thickness remained stable at each follow-up examination because the corneal epithelium was preserved during the operation.…”

Section: Discussionmentioning

confidence: 86%

“…Corneal cross-linking (CXL) is considered an effective treatment for halting or reducing the progression of keratoconus with increasing corneal biomechanical stiffness. The majority of published studies ( 4 – 7 ) have demonstrated the safety and efficacy of CXL for pediatric keratoconus; however, most of these studies focused on conventional corneal cross-linking (C-CXL; epithelium-off, 3 mW/cm 2 for 30 min) in the corneas of pediatric patients. Accelerated transepithelial corneal cross-linking (ATE-CXL; epithelium-on, 45 mW/cm 2 for 320 s) ( 8 – 11 ) has several benefits over the conventional method such as epithelium-on procedure, less treatment time, less intraoperative and post-operative complications, and greater comfort for the patients.…”

Section: Introductionmentioning

confidence: 99%

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One-Year Follow-Up of Corneal Biomechanical Changes After Accelerated Transepithelial Corneal Cross-Linking in Pediatric Patients With Progressive Keratoconus

et al. 2021

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Aims: This study aimed to investigate the corneal biomechanical changes and topographic outcomes of accelerated transepithelial corneal cross-linking (ATE-CXL) in pediatric progressive keratoconus.Methods: In this prospective longitudinal study, 31 eyes of 28 pediatric patients with keratoconus (21 boys and 7 girls; mean age, 14.35 ± 2.68 years) undergoing ATE-CXL (epithelium-on procedure with 45 mW/cm2 for 320 s) were included. Corvis ST was used to measure dynamic corneal response parameters at baseline and at 12 month after ATE-CXL. Corneal keratometry and corneal thickness were measured using Pentacam pre-operatively and 1, 6, and 12 month post-operatively.Results: No serious complications occurred during or after ATE-CXL. The maximum keratometry values were 60.10 ± 7.51 D pre-operatively and 61.42 ± 8.92, 61.17 ± 7.96, and 60.02 ± 7.58 D at 1, 6, and 12 month after ATE-CXL (P > 0.05), respectively. Corneal thickness remained stable during the 12-month follow-up (P > 0.05). At post-operative 12 month, first applanation time (P < 0.001), first applanation length (P = 0.004), second applanation velocity (P = 0.014), highest concavity time (P = 0.022), and radius of curvature at highest concavity (P = 0.031) increased significantly. The value of stiffness parameter at first applanation was significantly increased from 57.70 ± 27.57 pre-operatively to 63.36 ± 27.09 at 12 months after ATE-CXL (P = 0.018).Conclusions: ATE-CXL is safe and effective in stabilizing the progression of pediatric keratoconus. Changes in corneal biomechanical response consistent with stiffening following ATE-CXL were observed in pediatric patients with keratoconus.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

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One-Year Follow-Up of Corneal Biomechanical Changes After Accelerated Transepithelial Corneal Cross-Linking in Pediatric Patients With Progressive Keratoconus

et al. 2021

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“…There is small amount of information about rate of progression of untreated keratoconus eye. Or et al 25 have demonstrated that in a 5 year follow-up there was no progression for untreated eyes served as control eyes for fellow treated eye. Wittig-Silva et al 26 also used the fellow untreated eye as a control group, but offered a compassionate treatment after enrollment, thus eliminating the chance to acquire progression data for untreated eye.…”

Section: Discussionmentioning

confidence: 99%

Seven years follow-up of corneal cross-linking (CXL) in pediatric patients: Evaluation of treated and untreated eye

Simantov

Gazit

et al. 2021

European Journal of Ophthalmology

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Background: Retrospective cohort study evaluating long term keratoconus progression amongst cross-linking (CXL) treated pediatric patients in the treated and the fellow untreated eyes. Methods: Data on 60 eyes of 30 patients, 18 years old or younger, who underwent CXL in at least one eye was collected and analyzed. Follow-up measurements taken from the treated and untreated eye up to 7 years after CXL treatment, were compared to baseline measurements. Parameters included uncorrected distance visual acuity (UCDVA), best-corrected spectacle visual acuity (BCSVA), manifest refraction, pachymetry, corneal tomography, and topography. Results: Mean age of patients was 16 ± 2.1 years. For the treated eyes, during follow-up period mean UCDVA had improved (from 0.78 ± 0.22 at baseline to 0.58 ± 0.26 logMAR at 7 years; p = 0.13), as well as mean BCSVA (from 0.23 ± 0.107 at baseline to 0.172 ± 0.05 logMAR at 7 years; p = 0.37). The mean average keratometry showed a significant flattening (from 49.95 ± 4.04 to 47.94 ± 3.3 diopters (D); p < 0.001), However there was no change in the mean maximal keratometry. The mean minimal corneal thickness (MCT) showed a significant mild reduction of 26 µm ( p = 0.006). Although statistically insignificant, the mean manifest cylinder was also reduced to 2D ( p = 0.15). During the follow-up period, eight untreated eyes (26.6%) deteriorated and underwent CXL, while only one treated eye (3.33%) required an additional CXL. Conclusion: CXL is a safe and efficient procedure in halting keratoconus progression in the pediatric population, the fellow eye needs to be carefully monitored but only a 25% of the patients will require CXL in that eye during a period of 7 years.

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“…Por lo tanto, la progresión del KC en los niños es agresiva y puede que no se detenga por sí sola 26,37,40 . Esto puede llevar a un deterioro visual progresivo en los pacientes pediátricos y afectar su desarrollo social y educativo y, por lo tanto, afectar negativamente a su calidad de vida 45,46 .…”

Section: Discussionunclassified

Queratocono en edad pediátrica: características clínico-refractivas y evolución. Centro de Especialidades Médicas Fundación Donum, Cuenca, Ecuador, 2015-2018

Rojas-Álvarez¹

2019

Revista Mexicana De Oftalmología

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queratometría media, paquimetría en el punto más delgado y cilindro refractivo, en dos momentos. Se empleó el análisis de varianza (ANOVA) de medidas repetidas para un factor con ajuste del intervalo de confianza por Bonferroni y valor p. Resultados: Se obtuvo un aumento estadísticamente significativo entre el valor promedio de queratometría media de la muestra en el momento del diagnóstico (49.6 D) y el valor promedio de queratometría media a los 3 años de seguimiento (52.4 D) (p = 0.02; α = 0.05); una disminución estadísticamente significativa entre la paquimetría promedio de la muestra en el momento del diagnóstico (482 µm) y la paquimetría promedio de la muestra a los 3 años de seguimiento (459 µm) (p = 0.03; α = 0.05); y un incremento estadísticamente significativo entre el cilindro refractivo promedio de la muestra en el momento del diagnóstico (4.6 D) y el cilindro refractivo promedio de la muestra a los 3 años de seguimiento (5.1 D) (p = 0.01; α = 0.05). Conclusiones: Las modificaciones de queratometría, cilindro refractivo y paquimetría sugieren progresión de la enfermedad en este grupo de edad, en un periodo de 3 años.

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Corneal Cross-Linking in Pediatric Patients: Evaluating Treated and Untreated Eyes—5-Year Follow-Up Results

Abstract: Our long-term follow-up study suggests that CXL is a safe procedure in the pediatric age, and there is no urgency in treating pediatric patients with keratoconus without proof of progression.

Cited by 30 publications

References 22 publications

One-Year Follow-Up of Corneal Biomechanical Changes After Accelerated Transepithelial Corneal Cross-Linking in Pediatric Patients With Progressive Keratoconus

One-Year Follow-Up of Corneal Biomechanical Changes After Accelerated Transepithelial Corneal Cross-Linking in Pediatric Patients With Progressive Keratoconus

Seven years follow-up of corneal cross-linking (CXL) in pediatric patients: Evaluation of treated and untreated eye

Queratocono en edad pediátrica: características clínico-refractivas y evolución. Centro de Especialidades Médicas Fundación Donum, Cuenca, Ecuador, 2015-2018

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