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Naoko Kato, Takanori Sasaki, Kazuno Negishi, Ikuko Toda, Jun Shimazaki, Kazuo Tsubota; Outcomes of Corneal Collagen Crosslinking for Children under 14 years-old with Progressing Keratoconus. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4390.
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The efficacy and safety of the corneal crosslinking (CXL) to halt the progress of keratoconus has been proven by a lot of clinical trials. However, the outcomes of CXL for very young children (under 14 years-old) are limited. In East Asian populations, keratoconus tends onset earlier and be more progressive. We investigated retrospectively the outcomes of CXL for Japanese patients under 14 years-old with progressing keratoconus.
Five eyes of 4 progressing keratoconus children (3 males and 1 female, 1 case was 12 and the other 4 cases were 13 years-old) were investigated. CXL was performed with the epithelial off method. Following a 0.1% riboflavin instillation for 20 minutes, the thinnest corneal thickness (TCT) was measured, and when the TCT was thinner than 400 µm, distilled water was instilled until the corneal stroma was swollen to 400 µm or more. UVA was irradiated at 18.0 mW/cm2 for 5 minutes. The best-corrected visual acuity (BCVA), manifest refraction, steepest keratometric value (Ks), TCT and corneal endothelial cell density (ECD) were analyzed before CXL and 1, 3, 6 and 12 months postoperatively.
The BCVA was 0.24 ± 0.16 preoperatively and 0.20 ± 0.34 at 12 months after CXL. The manifest refraction (spherical equivalent) was -6.55 ± 4.86D preoperatively and -7.63 ± 6.97D postoperatively, and Ks was 49.64 ± 4.85D and 50.93 ± 6.57D, respectively. Two eyes resulted in increase in Ks of 1.0D or more 12 months after surgery, and one of them showed increase in corneal cylinder power of 4.8D postoperatively. The TCT (451.6 ± 55.7 µm preoperatively) and ECD (2704.6 ± 233.1 cells/mm2 preoperatively) were not significantly changed. Mild corneal haze was recognized in all eyes on 1 and 3 months after the CXL, however the haze disappeared or decreased after 6 months.
CXL was effective for halting the progression of keratoconus and safe in children under 14 years-old.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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