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M. Chammartin, R. L. Eschmann, B. E. Frueh; Outcome of Juvenile Keratoconus. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4318. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To analyse the course of juvenile keratoconus in patients younger than 18 years old.
We performed a retrospective study of 82 keratoconic eyes of 46 patients younger than 18 years at the time of diagnosis between 1977 and 2007.
The average age of the patients was 15 years (between 7 and 18 years). Of the 46 patients, 32 were male (69.6%) and 14 female (30.4%). 36 developed a bilateral keratoconus and 10 showed unilateral disease. 12 eyes underwent keratoplasty (14.63%), the remaining could be fitted with spectacles or contact lens. The average time between first consultation and operation was 4.75 years (from 2 months to 15 years) for a follow-up of 8.5 years (from 2 months to 29 years). The mean k-value was 50.64 diopters, 50.27 diopters for the eyes who were treated with spectacles or contact lens and 52.88 diopters for the eyes who underwent surgery. Of the 12 operated eyes, 4 developed acute hydrops, 3 had corneal scars and 5 were contact lens intolerant. There were no rejections episodes in the keratoplasty eyes. In the group of patients diagnosed at age 7 to 13 years, 7 out of 14 eyes had to undergo surgery (50%) and the mean k-value was of 49.32 D (51.65 D for the operated eyes).
In this group of young keratoconus patients, the corneas were very steep. Juvenile keratoconus can develope sometimes very rapidly, even faster in the subgroup of younger patients, and not rarely (4 out of 82) resulting in hydrops . Nevertheless, the majority of the cases could still be managed without keratoplasty.
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