Comparison of the efficacy of accelerated corneal cross-linking therapy in different pediatric age groups having progres
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ORIGINAL PAPER
Comparison of the efficacy of accelerated corneal crosslinking therapy in different pediatric age groups having progressive keratoconus Muhammet Derda Ozer Serek Tekın . Erbil Seven
. Muhammed Batur . Selma Mesen . . Tekin Yasar
Received: 6 March 2020 / Accepted: 23 May 2020 Ó Springer Nature B.V. 2020
Abstract Purpose To report a comparison analysis of accelerated corneal cross-linking (A-CXL) treatment for progressive keratoconus patients in different pediatric age groups. Study design Retrospective, cross-sectional. Methods Patients with progressive keratoconus aged B 18 were retrospectively reviewed. Forty-one eyes of 41 patients were included in the study. Patients were divided into two groups according to their age (B 14 years and 15–18 years). All patients underwent
M. D. Ozer (&) M. Batur S. Mesen S. Tekın E. Seven Ophthalmology Department, Faculty of Medicine, Van Yuzuncu Yil University, 65080 Tusba, Van, Turkey e-mail: [email protected] M. Batur e-mail: [email protected] S. Mesen e-mail: [email protected]
epithelium-off A-CXL protocol. Acquired data were compared between the two groups. Results The mean age was 14.3 ± 1.8 (10–18) years. Twenty-five (61%) of the participants were male, and 16 (39%) were female. Twenty (49%) patients were separated into group 1 (B 14 years of age), and 21 (51%) were in group 2 (15–18 years). Age at presentation was found to be the only factor in anticipating the progression of keratoconus at the second postoperative year visit (p \ 0.001). Progression in keratometric values was detected in seven (35%) of the 20 eyes in group 1, and one (4%) of the 21 patients in group 2 (Z = - 2.44, p = 0.014). Conclusion Even if proper treatment is applied, the progression of keratoconus is likely in patients younger than 14 years of age. Instead of evaluating pediatric patients as a whole, closer follow-up and early treatment may be useful in younger age groups (B 14 years). Keywords Keratoconus Accelerated corneal crosslinking Orbscan Keratometry Pediatric age
S. Tekın e-mail: [email protected] E. Seven e-mail: [email protected] T. Yasar S.B.U, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey e-mail: [email protected]
Introduction Keratoconus is a non-inflammatory corneal ectatic disorder characterized by progressive corneal thinning, scarring, and vision loss [1]. Pediatric keratoconus is usually diagnosed at an advanced stage as it
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has a rapidly progressive nature compared to the adult form [2]. Early treatment seems to be a suitable approach to stopping the progression and avoiding the need for keratoplasty in the long term [3]. Corneal collagen cross-linking (CXL) is intended to increase the non-covalent bond formation and corneal rigidity between collagen fibers using riboflavin and ultraviolet A (UVA) light [4]. CXL is the only method that can stop or slow the progression of keratoconus [5]. The standard Dresden (epitheliumoff) protoco
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