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Chiara Bonzano, Donatella Musetti, Riccardo Scotto, Carlo Alberto Cutolo, Fabio Licata, Carlo Enrico Traverso; Twelve-months functional results and confocal microscopic corneal features in pediatric and adult progressive keratoconus treated with corneal collagen cross-linking. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3506.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the functional and anatomical corneal changes after corneal collagen crosslinking (CXL) for progressive keratoconus (KC) in pediatric and adult population.
In this prospective study, patients with progressive KC underwent epithelium-off CXL. Pre- and 12 months postoperative examinations included: slit lamp examination, corneal epithelial fluorescein staining, best spectacle-corrected visual acuity (BSCVA), anterior segment optical coherence tomography, corneal topography and, in vivo confocal microscopy (IVCM).
Sixty-five eyes of 57 patients were included in this study. Twenty (31%) procedures were performed in pediatric patients (age <18), 29 (44%) in women. Preoperatively, pediatric and adult populations did not differ significantly in BSCVA and topographic, tomographic and confocal parameters. At 12-months, a slight but significant improvement in BSCVA was noted in mild cases (stages 1-2) but not in severe cases (stages 3-4). Central corneal thickness remained unchanged. Anterior corneal astigmatism reduction was -0.44 D (95% CI -0.76 to -0.11; p=0.01) and -0.60 D (95% CI -1.93 to 0.72 p>0.05) respectively in the adult and pediatric populations. In the severe stages, both corneal apex and surface asymmetry index decreased (p<0.05). At 12-months, IVCM showed stromal changes from baseline.
CXL for progressive KC is proven to be an effective and safe procedure. Our data show that both the stage of the disease and the age of the patients may influence both clinical and anatomical outcomes.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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