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Enrique O Graue, Andrew Gordon Olivo-Payne, Erick Hernandez-Bogantes, Alexandra Abdala-Figuerola, Arturo J Ramirez-Miranda, Alejandro Navas; Accelerated Epi-On Collagen Cross-linking for Keratoconus in Children. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3937.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effectiveness and safety of accelerated corneal collagen cross-linking (CXL) in children with keratoconus
Retrospcetive review of clinical records of patients <16 years of age with clinical and topographic diagnosis of keratoconus treated with accelerated transepithelial collagen cross-linking treated at the Insituto de Oftalmología Fundación Conde de Valenciana in Mexico City. Follow-up was done at day 1, week 1, 1, 3 6 and 12 months. Complete ophthalmic examination including subjective refraction and topography ( Sirius, CSO, Italy) were performed at each visit. Paired t test was used to compare the difference from baseline of evaluated parameters at each follow-up visit. The level of statistical significance was set at P < 0.05.
Fourteen patients (23 eyes) were included in the study. The mean age was 13.7 years ±1.4 (range 11-16) with an overall male to female ratio of 3:1. Mean follow-up was 12.75 months ±3.1 (range 9-16 months).Preoperative uncorrected distance visual acuity was 0.92 ±0.45 LogMAR. Postoperative UDVA was measured at 0.75 ±0.40 LogMAR, with a statistically significant improvement of -0.17 ±0.15 LogMAR (p=0.001) Preoperative BCVA was 0.26 ±0.30 LogMAR compared to postoperative BCVA: 0.15 ±0.15 LogMAR and had a statistically significant Improvement of -0.11 ±0.26 LogMAR scale (p=0.029).Preoperative mean keratometric (Km) readings were 53.63D ±5.84 and postoperative Km readings were 52.60D ±5.22D showing a significant Improvement of -1.02D ±0.79 D (p=0.029).Preoperative pachymetry was registered at 433 microns ± 37 at 12 months pachymetry was 431 ± 43 microns which translates to a non-significant corneal thinning of 2 microns ± 17 (p=0.36)
Preliminary results of accelerated CXL were encouraging, with no evidence of progression in over 95% of eyes over 12 months.
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