Abstract
Purpose :
There is limited North American data on the efficacy of corneal crosslinking for pediatric keratoconus, which is often severe at diagnosis and progresses rapidly. We performed a retrospective medical record review to assess the effect of corneal crosslinking on vision, keratometry and wavefront aberration in children and young adults with progressive keratoconus.
Methods :
We included patients aged ≤ 22 years with keratoconus who underwent corneal crosslinking between January 2013 and November 2019 at Byers Eye Institute at Stanford University. Outcome measures included logMAR corrected distance visual acuity (CDVA), keratometry and total wavefront aberration. Measurements were taken at baseline and 12 and 24 months postoperatively.
Results :
A total of 57 eyes of 49 patients aged 12-22 years were included. The mean preoperative CDVA was logMAR 0.38 ± 0.32 (20/48) and postoperative CDVAs were logMAR 0.29 ± 0.31 (20/39) and 0.31 ± 0.31 (20/41) at 12 and 24 months postoperatively. Compared to preoperative mean Kmax, there was an improvement of -0.8 D to a mean postoperative Kmax of 59.1 ± 9.1 D at 12 months and -1.3 D to 59.7 ± 8.8 D at 24 months. Linear mixed modelling showed significant improvements in Kmax at 12 and 24 months (p=0.013, p=0.001, respectively). In a sub-analysis of available wavefront aberration data, there were no significant changes in root mean square, defocus, astigmatism, coma, trefoil, tetrafoil, spherical aberration or second order astigmatism at 12 months postoperatively.
Conclusions :
Corneal crosslinking stabilized, and in some cases improved the visual, topographic and wavefront aberration parameters in pediatric and young adult patients with keratoconus. The procedure may prevent disease progression in this population.
This is a 2021 ARVO Annual Meeting abstract.