ophthalmologyОфтальмологияOphthalmology in Russia1816-50952500-0845Ophthalmology10.18008/1816-5095-2021-4-840-844ophthalmology-1688Research ArticleОФТАЛЬМОХИРУРГИЯOPHTHALMOSURGERYКератоконус у детей. Современные возможности леченияKeratoconus in Children. Мodern Treatment Optionshttps://orcid.org/0000-0002-4981-0755МарковаЕ. Ю.MarkovaE. Yu.

Маркова Елена Юрьевна, доктор медицинских наук, заведующая отделом микрохирургии и функциональной реабилитации глаза у детей

Бескудниковский бульвар, 59а, Москва, 127486

Markova Elena Yu., MD, head of the microsurgery and functional rehabilitation of children’s eye depart‑ment

Beskudnikovsky blvd, 59A, Moscow, 127486

markova_ej@mail.ruhttps://orcid.org/0000-0002-8474-8926АвакянцГ. В.AvakyantsG. V.

Авакянц Гоар Вардановна, врач-офтальмолог, аспирант

Бескудниковский бульвар, 59а, Москва, 127486

Avakyants Goar V., postgraduate

Beskudnikovsky blvd, 59A, Moscow, 127486

https://orcid.org/0000-0002-6732-1226КечинЕ. В.KechinE. V.

Кечин Евгений Владимирович, кандидат медицинских наук, научный сотрудник организационно-методического отдела

Бескудниковский бульвар, 59а, Москва, 127486

Kechin Evgeny V., PhD, researcher of the organizational and methodological department

Beskudnikovsky blvd, 59A, Moscow, 127486

ФГАУ НМИЦ «МНТК “Микрохирургия глаза” им. академика С.Н. Федорова» Министерства здравоохранения Российской ФедерацииРоссияS. Fyodorov Eye Microsurgery Federal State InstitutionRussian Federation202128122021184840844Copyright © Маркова Е.Ю., Авакянц Г.В., Кечин Е.В., 20212021Маркова Е.Ю., Авакянц Г.В., Кечин Е.В.Markova E.Y., Avakyants G.V., Kechin E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ophthalmojournal.com/opht/article/view/1688Цель

Цель: оценить результаты кросслинкинга роговичного коллагена у детей с кератоконусом.

Пациенты и методы

Пациенты и методы. Под наблюдением с 2017 года находятся 125 детей в возрасте от 4 до 17 лет, обратившиеся в ФГАУ НМИЦ «МНТК “Микрохирургия глаза” им. академика С.Н. Федорова» с жалобами на снижение остроты зрения и, в некоторых случаях, невозможность подбора оптической коррекции. Всем пациентам было проведено обследование, в том числе с применением высокотехнологичных методов (Sheimpflug камера, ОКТ). На основании анамнеза и полученных данных был поставлен диагноз «кератоконус I–III стадии». Проведен кросслинкинг роговичного коллагена 30 пациентам со II–III стадиями.

Результаты

Результаты. В исследование было включено 30 глаз 30 пациентов (21 (68 %) мальчик, 9 (32 %) девочек) с медианным возрастом 16 (15; 17) лет (от 12 до 17 лет), которым был проведен ускоренный «эпи-офф» кросслинкинг. Никаких интра- и послеоперационных осложнений не наблюдалось. Через 12 месяцев после CXL отмечалось замедление прогрессирования кератоконуса у детей (минимальная толщина роговицы до операции — 460,00 (445,00; 477,00), после операции — 457,00 (441,00; 477,00), р = 0,112; К1 до операции — 44,60 (43,20; 46,90), после операции — 44,60 (42,90; 46,50), р = 0,481; К2 до операции — 48,30 (47,30; 51,25), после операции — 48,20 (47,21; 49,20), р = 0,779; элевация задней поверхности до операции — 25,00 (18,00; 42,00), после операции — 26,00 (21,00; 42,00), р = 0,074, и повышение остроты зрения (НКОЗ с 0,30 (0,05; 0,40) до 0,30 (0,20; 0,40) (р = 0,039) и МКОЗ с 0,60 (0,40; 0,80) до 0,60 (0,50; 1,00) (р = 0,010)).

Выводы

Выводы. 1. Кератоконус встречается и в детской популяции. 2. Своевременное проведение кросслинкинга роговичного коллагена позволяет замедлить прогрессирование кератоконуса у детей.

Objective

Objective: to evaluate the results of corneal collagen crosslinking in children with keratoconus.

Patients and methods

Patients and methods. Since 2017, 125 children aged 4 to 17 years have been under observation, who have applied to the Eye Microsurgery named after Academician S.N. Fedorov with complaints of reduced visual acuity and, in some cases, the inability to select optical correction. All patients were examined, including using high-tech methods (Sheimpflug camera, OCT). Based on the anamnesis and the data obtained, the diagnosis of keratoconus stage I–III was made. Corneal collagen crosslinking was performed in 30 patients with stage II–III.

Results

Results. The study included 30 eyes of 30 patients (21 (68 %) boys, 9 (32 %) girls) with a median age — 16 (15; 17) years (12 to 17 years), who underwent accelerated “epi-off” crosslinking. No intra-and postoperative complications were observed. 12 months after CXL, there was a slowdown in the progression of keratoconus in children (minimum corneal thickness before surgery 460.00 (445.00; 477.00), after surgery 457.00 (441.00; 477.00), p = 0.112; K1 before surgery 44.60 (43.20; 46.90), after surgery 44.60 (42.90; 46.50), p = 0.481; K2 before surgery 48.30 (47.30; 51.25), after surgery 48.20 (47.21; 49.20), p = 0.779; elevation of the posterior surface before surgery 25.00 (18.00; 42.00), after surgery 26.00 (21.00; 42.00), p = 0.074, and increased visual acuity (NCOZ from 0.30 (0.05; 0.40) to 0.30 (0.20; 0.40) (p = 0.039) and MCOZ from 0.60 (0.40; 0.80) to 0.60 (0.50; 1.00) (p = 0.010)).

Conclusion

Conclusion. 1. Keratoconus is also found in the child population. 2. Timely cross-linking of corneal collagen can slow the progression of keratoconus in children

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The authors declare that there are no conflicts of interest present.