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Regina Velasco, MIGUEL LOPEZ-DIMAS, ALEJANDRO BABAYAN-SOSA, Oscar Fernandez Vizcaya, Elisa Alegria Gomez, Cristina Pacheco Del Valle, Oscar Baca Lozada; Corneal Topographic Characteristics after Crosslinking in pediatric patients after one year follow-up. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6320.
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To determine the topographic characteristics of progression in pediatric patients with crosslinking Epithelium-on (Epi-on) or epithelium-off ( Epi-off) after one year follow-up
Ambiespective study of pediatric patients with Keratoconus, whom underwent crosslinking Epi-on or Epi-off to stop progression from January of 2016 to October of 2017. We included 80 files at the Cornea department. All patients had a corneal topography Orbscan IIz (Bausch & Lomb) before and after the surgery. The variables were: uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) on logMAR scale, maximum and minimum keratometry, central and thinnest pachymetry and posterior elevation. We divided the patients into two groups: a) Epi-on and b) Epi-off. Inclusion criteria: Patients ≤18 years undergoing Crosslinking epi-off or epi-on due to Keratoconus, with the thinnest central pachymetry ≤ .400 mm, with absence of other ocular pathology. The data was analyzed with GraphPad PRISM®5.00. We applied normality tests Kolmogorov Smirnov, D'Agostino and Pearson, Shapiro Wilk, and later tests of paired t, unpaired t and Wilcoxon test
: We included 52 eyes of 51 patients. Group a 21 eyes, mean age 14.85 years (8-18). Group b 31 eyes, mean age 15.70 years (10-18). Mean improvement UCVA after Epi-on or Epi-off - 0.12 logMAR (p 0.09) and - 0.04 logMAR (p= 0.32), respectively. Mean improvement in BCVA - 0.11 logMAR (p 0.12) and - 0.03 logMAR (p 0.26), group a and b respectively. Mean increase in maximum keratometry of +0.11 D (p 0.67) and +0.19 D (p 0.31), mean decrease in minimum keratometry -0.05 D (p=0.82) and -0.11D (p= -0.11) after Epi-on or Epi-off respectively. There were no significant difference in group a) regarding changes in central pachymetry and thinnest pachymetry (p=0.67 and p=0.52 respectively), on the other hand, in the epi-off group, there was a significant difference in central pachymetry (p = 0.005) and thinner pachymetry (p = 0.004). Average change in posterior elevation was -0.001 mm (p = 0.601) and +0.027 mm (p = 0.004) Epi-on or Epi-off respectively.
After one year follow up pediatric patients undergoing crosslinking epi off had visual stability without progression and patients in the epi on group had visual improvement as well an increase in maximum keratometry. Cross linking is an effective therapy to stop progression in pediatric patients with keratoconus
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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